


Causality

by J_Baillier



Series: You Go To My Head [9]
Category: Sherlock (TV), Sherlock Holmes & Related Fandoms
Genre: Alternate Universe - Hospital, Angst, Death of prominent but not major character, Discrimination, Doctor!John, Doctor!Sherlock, Drug Addiction, Established Relationship, Family Issues, HIV/AIDS, Homelessness, Homophobia, Hurt/Comfort, Inequality in healthcare, Infectious diseases, Insecure Sherlock, LGBTQ Themes, M/M, Major character death is not Sherlock or John or any of the series regulars, Multiresistant bacteria, Mycroft Worries, Occupational Hazards, Pining, Romance, Sherlock Holmes and Drug Use, Sherlock's Past, anaesthesiology, commitment issues, neurosurgery
Language: English
Status: Completed
Published: 2018-05-31
Updated: 2018-06-13
Packaged: 2019-05-16 12:55:57
Rating: Mature
Warnings: Creator Chose Not To Use Archive Warnings, Major Character Death
Chapters: 6
Words: 31,232
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/14811786
Author URL: https://archiveofourown.org/users/J_Baillier/pseuds/J_Baillier
Summary: While John battles killer viruses, resistant bacteria, and fears over his own health, Sherlock meets a ghost from the past.





	1. Chapter 1

**Author's Note:**

> I didn't know how much I wanted to tell this story, until I began writing it. It deals with a tragic chapter of medical and social history as well as civil rights issues which have haunted me since I saw the film _Philadelphia_ in my preteens. At its core are the ways in which society and much of the medical establishment shamefully abandoned the first wave of patients during the emergence of the HIV epidemic. There are many works of fiction I have enjoyed and been touched by regarding this topic – including _Angels in America, Don't Dry Tears Without Gloves_ and _The Normal Heart_ – and I can only hope some of them might echo in this story. This fic also deals with the ways in which equality is still a faint dot in the distance when it comes to how certain patient groups are treated in public healthcare. I don't work in the NHS and can only hope that the issues depicted here are of the past; however, seeing as I work in a country at least as liberal as the UK and still see how badly sexual and neurodiversity is taken into account in our system, I am a little sceptical. 
> 
> **It is not often that I find myself presenting a warning at the start of a fic about its contents**. This time I feel that I must, because I recognise that the themes and events described here will touch some readers on a very personal level. Good news first: while both Sherlock and John will have to deal with some difficult things in _Causality_ , the journey they took to repair and rekindle their relationship in _Scar Tissue_ will bear quite wonderful fruit. More importantly, **the major character death is not John's or Sherlock's, or even any of characters you have already met in this series**. However, the event of that death is described in detail. If you have an inkling that this is something that you might wish to hop over, you can go straight to the last chapter to re-join our two doctors. **An additional controversial issue arises from religion's role in one character's discriminatory attitudes; see the author's notes at the end of chapter one for more commentary on this.**
> 
> As always, I am in great debt to my partner-in-crime 7PercentSolution, and also ASilverGirl who provided very helpful additional beta.

 

  
**"In times of stress and danger, such as what comes about as the result of an epidemic, many tragic and cruel phases of human nature are brought out, as well as many brave and unselfish ones.”**  
**― William Crawford Gorgas: " _Sanitation in_ _Panama_ "**

 

A crisis assembly of A&E, OR and ITU staff has been going on for forty minutes, and the volume of Greg Lestrade's voice has been rising steadily during the proceedings. If the noise of the spontaneous protests coming from the audience doesn't start winding down, he'll soon be forced to shout into the microphone.

Most of the attendees are nursing staff; there are only a handful of registrars representing the doctor contingency, commanded to attend by their consultants who couldn't be bothered. This means that the unit heads are forced to weather the storm without much backup from their colleagues.

John, standing next to Greg on the podium, shakes his head before shifting the microphone closer to himself. "The Ebola scare seems to have passed, and we survived the TBE crisis. CARDS can't be much worse; if everyone just looks at this rationally----"

There are more protests from the crowd and John trails out, shaking his head. It's understandable that the King's College staff are so worried, but they do need to work this out together. Epidemics do come and go – even the annual influenzas can be categorised as full-blown pandemics – but the _CA_ ucasus _R_ espiratory _D_ istress _S_ yndrome is proving to be quite a frightening one. There are now a couple of cases just across the English Channel, and even with advanced intensive care, the fatality rate is in the high sixties. There is no cure and no vaccine yet, and the coronavirus causing it can be spread by airborne transmission just like influenza. In Turkey, it had claimed the lives of several healthcare workers before the novel coronavirus was even identified and proper isolation measures put into place.

The nursing staff on the front lines of new patient intake, and those who would be looking after the most severely stricken are being the most vocal. Neither Greg nor John are in charge of the Critical Care services or the A&E department, but as part of the taskforce to formulate Trust guidelines for the management of this public health crisis, they were asked to lead the four staff assemblies consulting with all internal interest groups. The taskforce comprises of some higher-ups from the Trust admin, all the medical and surgical unit heads, John as the Clinical Director of Operative services, his counterpart director of medical services, representatives from the hospital hygiene unit, and a specialist from the infectious diseases clinic.

Fiona Lansing, the Ward Sister of the A&E department, stands up, pointing her forefinger accusingly at the two doctors. "It's bloody easy for _you_ to say that we should calm down, since you and all the other surgeons will be safely hiding in the OR. We're the ones on the front lines! At least give us a guarantee that we'll have enough proper safety masks and other gear – ITU and the theatre floors always have those bulging out of their closets, but we have to make do with the cheap stuff!"

Lansing's comment spurs on a few ominous cheers from the back rows. John doesn't even try to explain how budgeting and acquisitions work and that money cannot be magically moved from one Excel spreadsheet into another. He does often wish it could be, since initially it does all come from the government.

Greg takes over the microphone again. "True, the OR always has a stock of filter masks because we never know when we get a patient whose care requires those, but that stockpile is much smaller than what A&E has. Their use at A&E regulated by guidelines which the department has formulated themselves with the help of the hygiene unit," Greg points out and then directs his gaze to a sixty-something man sitting in the front row. "Maybe Doctor Hyong could comment on what sorts of protective equipment is known to be needed."

A second-generation South Korean immigrant, Hyong has been the head of the King's College Hospital's infectious and tropical diseases' unit for decades. He climbs to the podium and John steps aside to give him space by the microphone.

"Based on what we know about MERS, the CARDS coronavirus requires at least a fit-tested NIOSH-certified disposable N95 particulate filtering face piece," Hyong explains.

"Those are at least seven pounds apiece," John points out. "We'll need a house-wide guideline on when to use them to prevent a disastrous budget overdraft."

One of the ITU nurses seated in the front half of the audience stands up with her arms crossed. "Shouldn't the government give us extra funds for this? Nobody could have anticipated this shit going down!"

"Those who have children should be released from duty to care," a thirty-something dermatology registrar in the front row suggests. "The mortality rate's _sixty-eight percent_!"

"Let's just calm down, please," John placates. "We all have important people in our lives depending on us, but we must keep in mind that we all have voluntarily chosen our line of work and accepted the risks it entails."

There's a snort from the registrar. "It's obvious that _you_ haven't got kids."

John chooses to ignore that. "The latest WHO bulletin says that the initially reported mortality rate is likely very much overestimated, since they have learned that the virus can be asymptomatic or just cause a mild, common cold -like disease. They have no way of knowing what the actual number of cases is, so the mortality rate is a wild estimate at best. Is the quick test available yet for the virus?" he asks Doctor Hyong.

The older doctor nods courteously. "We will know within an hour after a patient's arrival whether they carry CARDS or not, so they can be isolated."

"They'll infect the whole waiting room and half the staff in that time!" Fiona Lansing exclaims. "We need to cohort everyone who comes in with flu symptoms. Maybe set up a separate entrance for them?"

Doctor Hyong gives her a stern glance. "Then you would risk infecting those who only have a much more benign respiratory infection. If we start seeing significant numbers of suspected cases, we _will_ be setting up a separate cohort clinic, but the NHS-wide plans for those are not ready yet."

"What about the family members of the infected patients? A kid comes in, spreads CARDS snot all over the place, and their parents might be already carrying the virus, too," an ITU nurse suggests. "Shouldn't we at least close down all visiting at the Critical Care wards?"

"Not until there is a confirmed case in the UK. The NHS and the ministry of health are preparing an information campaign which will be put to action if, or when, the epidemic spreads here. The general public _will_ be advised. We can't start making up too many rules of our own before the national experts have a consensus," John explains.

"We're short on ITU beds as it is. Where do we put the CARDS cases who need a respirator?" the same ITU nurse asks.

"Assuming anyone will even recognise them," an A&E registrar pipes in with a bitter tone; "Did you hear what happened to that American doctor who got Ebola two months ago? I heard they turned him away from an A&E because they didn't believe he could have it, even if he told them he'd just flown home from Africa!"

"The two Americans medevaced home last month from Congo due to Ebola were both diagnosed locally and transported in isolation," Doctor Hyong announces sternly. "We need to stop spreading rumours and hearsay. With any luck, there will be a vaccine before a full-blown epidemic arrives, assuming it ever does."

"I'm not taking some dodgy new vaccine!" comes a Welsh accent from somewhere in the middle of the auditorium. "Look at what happened with the swine flu one!"

Doctor Hyong sighs. John knows how much work he does on educating healthcare workers about the benefits of the annual influenza vaccinations. "If you're referring to what happened in some Scandinavian countries when the epidemic vaccine triggered narcolepsy, that's still under investigation and it appears that there may be something in their regional genetic makeup which predisposed them to that. Influenza viruses themselves can also trigger narcolepsy, so there's no way to know how many cases would have been seen without the vaccine."

"So, what you're saying is that there are no guidelines yet? What the hell do we do, then, if CARDS gets here?" an incredulous emergency physician from the A&E department asks. "We'll still have all the other patients at A&E – how do we protect them?"

Hyong clears his throat. "That plan is for every patient to fill an electronic questionnaire before being signed in at A&E. If they have risk factors pointing to possibility of infection, a nurse wearing protective gear will meet up with them and escort them to an isolation area for the mucus sample. The microbiology unit has promised to provide 24/7 coverage of the quick testing. Within an hour, they can be released into the general A&E patient population if the test is negative."

"What are the risk factors?" Greg asks.

"Travel to endemic areas, contact with suspected or diagnosed cases, typical symptoms and so on," Hyong lists.

"We should isolate everyone who's been east of Austria or Poland!" someone from the back row suggests.

A man from the front row rises to his feet and strides to the podium to close to the microphone. He's Paul Kerr, the Trust's Head of Communications – and, in John's opinion, a stuck-up idiot. "We can't start any sort of ethnic profiling. That is off the table, and there will be no further discussion on the matter."

It irks John that he's right, even if his opinion stems mostly from a PR standpoint – ethnic profiling of A&E patients would lead to King's College being on the front page of all the tabloids in an instant.

"As Doctor Hyong said, what we _can_ do is screen potential high-risk patients and test them," Kerr points out, "The electronic survey system which will be used to screen all arriving A&E patients has been tested, and the installation will happen next week unless we start seeing cases earlier in the UK," Kerr reassures the audience.

This seems to satisfy at least some of them.

Hyong speaks up again. "The cases in France have all been among travellers to Pakistan or Turkey, and despite close contact with family members, surprisingly little collateral transmission has happened. When the fulminant symptoms producing airborne particles come to full swing, many patients are already in so much respiratory distress that they have been hospitalised. In a way, this functions like Ebola does – burns itself out so dramatically and quickly – that the epidemic potential is not as bad as we think. The disease is still considered contained."

"But it's less than two hundred kilometres away, in France!" a janitor from the ITU points out. "You can't judge us for being worried. Any moment someone carrying it could walk off a plane at Heathrow or a ferry at Dover."

"I'm worried, too," John points out. "But that was just _two_ cases in France; we never know at any given day what could walk in the door at A&E – CARDS or no CARDS. Every day, any A&E patient might be carrying who knows what, creating a risk for us when we treat their meningitis, pneumonia or abscesses. At least with CARDS, we have an advance warning that it might be coming." Only last year John had intubated a young woman at A&E because she had lost consciousness, and when her spinal fluid had been analysed and the _Neisseria meningitidis_ bacteria discovered there, all who had participated in her care had been given a dose of antibiotic as a precaution. Any patient coming in the door could also be harbouring MRSA, VRE or some other resistant bacteria asymptomatically on their skin. Any elderly patient could be a carrier of hepatitis C from a blood transfusion administered decades ago, when testing for blood-borne diseases was not as close to fool-proof as now. Former intravenous drug users cannot be recognised just by looking at them, and they might be carriers of a chronic viral infection. All who work within the walls of any hospital are at a higher risk of encountering infectious patients than the average person, but they also have better means at their disposal to protect themselves.

John leaves the stage to Kerr, Lestrade and Hyong and goes to sit in the front row, digging out his Blackberry to skim through his emails while the assembly continues. He has never paid much mind to the infection risks of his job because whatever may lurk in the surfaces and corridors and patients at King's, it could just as easily be caught from an escalator banister at a shopping mall.

 

-o-0-o-0-o-0-o-0-o-

 

Sherlock leans back against the chair and decides against an eye-roll. He had planned on just dropping off some paperwork in Greg Lestrade's office, but the man had been in and commanded him to sit in this chair and be lectured about the proper chain of command regarding OR equipment acquisitions. Lestrade seems to be in a bad mood – perhaps the CARDS assembly Sherlock had skipped has not gone smoothly. He hadn't attended, because he knows that, as a surgeon, he's well-protected from any epidemic. Any acute neurosurgical patient he'll be asked to assess will have been already risk-assessed and tested for CARDS by the time he gets involved. It's the nursing staff and the emergency doctors on the front lines of A&E departments who need to worry. John has been griping for weeks now about the CARDS Task Force he had been ordered to join; everyone is just trying to dump their complaints on the group instead of offering any constructive suggestions regarding how to solve those issues. It doesn't help that the NHS seems to be expecting its Trusts to shoulder whatever extra costs the epidemic will bring.

It's always about money.

"Are you even listening?" Lestrade asks, and Sherlock blinks back into the present. He has no idea what his superior has been saying, if anything, during the past few minutes. _Most likely nothing important_.

Lestrade purses his lips in annoyance. "You can't just command the Ward Sister to order whatever instruments you like! I know that poor woman is no match for you, but if stuff just keeps popping up with bills attached, and nobody knows what the hell that stuff is for, or whose budget it's supposed to come out of, or how the damned warranties work, or who does the maintenance, or who's responsible for keeping the damned thing in working shape, then the whole system just falls apart! Everything needs to have a paper trail and a budget bracket, and we need to justify the costs to the Trust's Chief Executive! "

"What if I pay for the purchases myself?" Sherlock can afford it, but John has told him not to flaunt that fact. Why hasn't he realised before that he could circumvent the whole bureaucracy if he could order directly from MedTronic the specialty stuff he occasionally needs for posterior fossa surgery, which he assumes this is about.

"That wouldn't solve even _half_ the problems I just listed. There are liability issues if we're using stuff that isn't on our books. Just please, _please_ talk to me first before you start pining for some new toy. You can operate perfectly well with the stuff we've got. You don't need every single gadget some rep tries to peddle to you."

"I am _not_ gullible," Sherlock scoffs. "It's you who's standing in the way of progress."

"No more ordering through Margaret. You come to me, when you need something. Is that clear?"

"If she isn't competent to deal with her job, she ought to be---"

"Am. I. _Clear_?"

Sherlock rises from the chair to leave. Lestrade will have to accept his glare and sigh as a yes.

"Not so fast," Greg commands. "Occupational Health called. You're _four_ bloody years overdue for your mandatory check-up."

"I delete all of OH's emails. What mandatory check-up?"

"Trust policy. Looking after our employees and all that."

Sherlock harrumphs. "What is this – National Jump Through the Hoops Day? I never pegged you for such a stickler for rules."

Greg shrugs. "If it helps, I told them to book you in for this afternoon, so you wouldn't put it off. Marie promised to rebook a couple of your outpatients. Your appointment's at half past two."

"This year I have already been poked and prodded and examined for a few decades' worth by Laura Arthur," Sherlock protests.

"You know that's not the same."

Sherlock rolls his eyes and turns to leave again.

"One more thing," Greg tells him.

"What  _now?!_ "

"You haven't done your compulsory annual trauma team simulation. All consulting surgeons and registrars are required to do one."

"Since when?"

"Since last year."

"Oh, for the love of----" Sherlock mutters, and marches out of the office.

 

-o-0-o-0-o-0-o-0-o-0-o-

 

"Mister Holmes, come on in."

Sherlock reluctantly shakes the outstretched hand of the fifty-something occupational health nurse. He knows the clinic sees plenty of patients with acute infections and many such clinics have adopted a sensible practice of not shaking the hands of patients to limit transmission.

The nurse, whose nametag is adorned with a cheery red flower sticker, reads S. Moreland. She has thin, greying hair cropped to a short cut likely for ease of maintenance, a smoker's yellowish nails, and she's wearing a thin gold chain but if there's a pendant it's is hidden underneath her blouse. The horizontal surfaces of the smallish appointment room are nearly overflowing with leaflets about various health education issues, and the curtains are worn and sun-discoloured.

A chair reserved for patients has been shoved uncomfortably close to her desk. "Have a seat," she prompts perkily.

Sherlock tries to stifle his mounting irritation. He has an avalanche of paperwork to finish – this sudden appointment being sprung on him means that he didn't even have time to dictate today's notes for a patient he's been following up on a neurology ward to see if their paralysis symptoms might warrant spinal surgery.

"We'll go through the basic check-up package, and then if there is anything you would like to talk about regarding your well-being at work, I'm sure we'll have plenty of time left for that as well," the nurse explains.

Sherlock purses his lips. This is nothing but yet another example of idiotic NHS bureaucracy eating into actual patient work. If he needs medical attention, he will talk to a sensible consultant of the appropriate specialty and get things sorted quickly and efficiently. He doesn't _need_ a checkup.

"I see you have answered our questionnaire," the nurse says sunnily.

Sherlock gives her the two sheets of paper he'd filled out while sitting in the hallway. "Very perceptive of you."

The nurse blinks, then looks as though she hasn't understood the barb.

Sherlock realises that John would probably tell him to behave at this point, reminding him that it isn't the nurse's fault that the Trust is making him jump through such hoops. Still, it depends very much on her how much of his valuable time this is going to steal.

"Alright, so it says here that you are a neurosurgeon. What does that entail?" she asks.

"Excuse me?"

"Could you tell me about the nature of your work?"

"I operate on the brains and spines of patients. I have one and a half days of tiresome outpatient clinic work per week, and ward consultation responsibility one day a week. I oversee trainees' procedures when I must."

"I see. Do you take call?"

"Of course. About five times a month."

"Do you have to stay in the hospital for that?"

"If a neurosurgical registrar is available, I may leave the building if I'm not needed, but mostly I stay in since urgent cases tend to stack up during night hours since gastro always manages to monopolize the OR teams and the anaesthetists until then." He crinkles his nose in distaste. Arguing with other surgeons about when he gets to operate is one of his least favourite things. He's not the only neurosurgeon who has been trying to push the Trust to employ an extra OR night team earmarked for their specialty.

"That means that you need to be added to our registry of employees with significant night work hours."

"And the purpose of such a registry is?"

"Monitoring the health effects of working at such hours."

"How do you prove cause and effect?"

"What do you mean?"

"How do you discern whether an employee's health issue is related to working nights in any statistically significant manner?"

"That's for our doctors to decide."

"I see." Sherlock really doesn't, but it's obvious this nurse is clueless about proper scientific research.

"Do you get exposed to noise, chemicals or radiation in your work?"

"Unless you count the inane chatter in break rooms, no to the first. I can’t say I am very fond of the high-pitched whine emerging from the hospital’s fluorescent bulbs, but I have learned to deal with it and I doubt it qualifies. It should be a yes to the second for _all_ employees since the hospital uses disinfectants and potent cleaning solutions. As to the third, yes, since spinal surgery requires X-rays to localise the appropriate surgical entry site."

"Do you carry a personal dosimeter?"

"Yes."

"Good, good, that's good." The nurse consults her computer. "It says it was read two months ago and no significant exposure was registered."

"If you already had that information available, why did I have to fill out that part of the questionnaire and be quizzed about it?"

"It's routine," the nurse replies as though it's any sort of an explanation. She then ploughs on: "Are you exposed to violence in your line of work?"

"Some of my patients have contracted brain injuries from accidents and violence, yes."

"I meant violence or threats of it against _you_."

"Some of our emergency room patients can be aggressive, but I am rarely the first one on site, or the one who needs to physically restrain them." Sherlock is aware that he is protected to a greater degree than many at the hospital. It's a much bigger issue for John, who often has to start IVs on very restless and aggressive patients so that they could be sedated.

Next, the nurse goes through some general health questions. Sherlock refuses to get on the scales in the corner of the room, but he does divulge what his weight had been when he'd last checked.

"You're underweight for your height," the nurse announces bluntly.

"Says who?"

"The guidelines."

Sherlock refrains from telling the woman that John has been making similar remarks about his weight for years, and the school nurses used to sing that same song. Food simply does not register very highly on his hierarchy of priorities. He knows he'd lost quite a bit of weight during the halo debacle, but John has made sure he has already gained much of it back.

He's always been thin. What of it? "Those guidelines are based on averages. I have never been, and never will be, an _average_ person," he says dismissively.

The nurse gives her a confused glance, then quickly flips to the next page. "Time for your blood pressure!" she announces enthusiastically.

"Must we?"

"It's routine."

Sherlock wants to scream at the idiocy of such logic, but still obediently removes his jacket. John would probably tell him that co-operation is the quickest route to getting out of this.

The nurse slides a tourniquet up his arm. Soon, there's a reading available. "104/68, pulse 73. That pressure is... a bit on the low side. Most people---"

Sherlock silences her with a glare and she puts the machine away.

"You don't get dizzy standing in the OR?" she asks, frowning at him.

"I'm sure some busybody would have tattled to OH if I did." Although his relationships with King's College staff have improved during the past two years, Sherlock is sure that there are still plenty of people who wouldn't rejoice at finding such ammunition against him.

"Do you have good working relationships with your colleagues?"

"No. Except for the head of the neurosurgical unit."

"Could you elaborate?"

"Let's see. Greg Lestrade is fine – he is that head. Philip Anderson is an idiot, and the rest are tolerable only in small doses. They generally prefer to see very little of me, so it all works out well when I endeavour to have as few dealings with them as possible."

"What about trainees? Do you currently have anyone assigned to you?"

"No. I have an agreement with Lestrade over having extra ward duty in exchange for not overseeing any registrars or fellows." The thought of having someone's specialist training depending on him is just---- he's not cut out for it. It would surely be a disaster.

"How is your work satisfaction?"

Sherlock crosses his arms. "Good, as long as other people leave me to it and don't bother me with bureaucratic nonsense," he answers pointedly.

"Is there anyone at work you feel you can turn to for advice and support if you need it?" She seems to be reading these questions from some list on her computer.

"I told you; I get along with my immediate superior, so it's _fine_." He refrains from mentioning John, because he hates sounding like he'd go over his Lestrade's head if he's got a problem.

The nurse is still squinting at her computer. "It says here that Mister Lestrade contacted us some time ago on your behalf."

Sherlock curses inwardly. He had hoped this wouldn't come up, but since it's in the OH records he shouldn't be surprised.

"You had an appointment reserved three days after he called us, which you didn't attend or cancel."

"Lestrade booked that appointment without any input from me." Since he had showed up at work and insisted to Greg that he was fine, the older surgeon had not pressed the issue.

"Mister Lestrade told the OH doctor who took the call that there were significant relationship stressors in your life, and because of that you were not able to sleep. Are those issues still ongoing with your girlfriend?"

"My girlfriend?" Sherlock keeps his tone neutral.

"Your... wife? It seems Mister Lestrade hadn't specified, and we don't have any information on a significant other in our files."

Usually such information is gathered from new patients when they are signed in to A&E or an outpatient clinic for the first time, but Sherlock hadn't physically set foot in the OH clinic when John had been in Afghanistan. They hadn't even gone through this stuff at A&E when he'd contracted his neck injury, because he'd been initially assessed through the proverbial back door after the janitor who had found him had dragged the orthopaedist on call to have a look. The staff of the Orthopaedics & Trauma outpatient clinic had probably assumed that his personal information had already been sorted out at A&E. Thus, the updating of his files with John's contact information has never happened.

"No, those issues are not ongoing. _John and I_ are fine," Sherlock answers slowly to hammer in his point. He then leans back in his chair and watches the realisation sink in.

The nurse is clearly doing a double take. "Oh, you mean--- _Oh_."

Sherlock raises his brows when she doesn't continue bombarding him with more pointless questions.

Finally, she poses a question, this time much more hesitantly: "Have you received counselling for that?"

"For what?"

"For, well---- your lifestyle?"

" _Lifestyle_?" Sherlock's eyes narrow into slits. "There's nothing wrong with my lifestyle," he replies with a gravelly voice.

The nurse opens her mouth again, but Sherlock's glare seems to make her rethink what she wants to say. She clicks around a bit on her computer. "Well, what about your diet?" she hastily asks, looking flustered. She readjusts her blouse and Sherlock can now see a cross hanging in the gold chain around the neck. The pendant is accompanied by opulent red stone beads that give it an air of a rosary.

 _Likely Catholic. Colour me unsurprised._ "Diet?" he repeats.

"Yes. Meal schedules, that sort of thing."

"I've never had a meal schedule and I'm not about to start now."

"Do you eat breakfast?"

"Yes." If he doesn't, John will nag about it and drag him into the hospital's abysmal cafeteria, and admittedly he does operate better if he's had something in his stomach besides just coffee.

"What about lunch? Do you always have it at the same time?"

"I'm a _surgeon_. I can't really drop what I'm doing and go eat; the patients just _might_ complain if I left the OR to have lunch in the middle of brain surgery." During a particularly long operation, or if he has to wait while a pathologist looks at slides a quick-frozen sample of a tumour he's removing, he might take a break if he can, but that would happen way past lunchtime. Sometimes he requests juice or coffee with a straw in the OR if a case really drags on.

"If you sometimes have to delay lunch, you might want to consider having oatmeal with egg added in for breakfast. You'll need the protein."

Sherlock cannot decide whether he should laugh, cry or walk out. The mere thought of oatmeal porridge makes him want to retch; the gelatinous texture is revolting. He opens his mouth, but whatever he might say will only lead to more trouble, so he snaps it back shut and hopes for a fire alarm to go off.

"Are you still having trouble sleeping?" the nurse asks.

"I have never had what you'd call a normal sleeping schedule. I require very little of it, and the current situation is acceptable." Sherlock replies coldly. He's had it with this interrogation.

"Do you find that lesser sunlight during wintertime affects your alertness or mood?"

" _No_."

"Have you had any musculoskeletal issues during the years you've been with us that might have affected your work?"

Sherlock blinks. "You cannot be serious."

"You might be surprised how many surgeons develop things such as tendinitis----"

"Quite recently, I broke my _bloody neck_ , which should be blindingly obvious from your records since I was on sick leave for _thirteen weeks_. I would appreciate it if you took a moment to browse through whatever drivel has been written down in the rest of my records so that I wouldn't have to keep explaining the obvious."

"Apologies, Mister Holmes. We deal with many patients each day; it is difficult to keep tabs on all the details."

"For you, perhaps. _Are we done_?"

"Would you be interested in having your cholesterol levels measured?"

"No, I really am not."

She looks disappointed, as though she had actually assumed he'd want to extend this check-up beyond the absolute minimum of time wasted.

Sherlock rises from his chair, does not extend his hand, and turns to leave. He hears the nurse rummaging around the bottom drawer of her desk but opens the door anyway.

He's just about to slip into the hallway when the nurse calls out for _Mister Holmes_ again.

Sherlock has never been very fond of that archaic form of addressing surgeons. Some of his non-surgical colleagues think that it's snooty and pretentious, but to Sherlock is has always felt the opposite: diminishing. He'd prefer to be a doctor by title, instead of sounding the same as any Mister Joe Bloggs.

The nurse has circled her desk and is offering him some sort of a leaflet, which he takes to see what it's about. The cover image is that of a pair of joined hands. The headline is _'A Guide to Safer Sex Between Men Who Have Sex With Men_ '.

Before, Sherlock had been bored, disappointed and annoyed. Now, he's angry. He doesn't even check which organisation has produced this leaflet or what it contains – it's not important. Instead, he rolls it up and points it at the nurse as though holding a sword. "I assume every one of your clients receives a similar waste of paper?"

"No, I just---"

"If not, then the only possibility is that you think I need such advice because A: you assume that since I am a homosexual male, I must be outstandingly promiscuous, and B: despite being a physician, I am an imbecile and thus utterly incapable of self-protection. Would you like me to put your mind at ease by, say, demonstrating right now, right here that I am perfectly familiar with the proper installation of a condom?"

The nurse gapes. "Young man, I'll have you know I am not paid enough to take such language from you!"

Sherlock isn't done. "Or, perhaps you might want me to call John to join us, so you could interrogate him as well about the details of our bedroom habits which so disturb you. I'm sure he'd be just as delighted to learn that you obviously think you have the right to presumptuously breach my privacy regarding a manner that has _nothing whatsoever to do with your work_?"

"I'm only doing my job," the nurse stammers. "I have heard that gays have very high rates of sexually transmitted diseases, mental health problems and drug abuse, and I just thought---"

" _Don't_ , since you are obviously unsuited to such a pastime. Shall we make a deal? I refrain from reporting you to your superiors for discrimination, and you will make sure I am never again summoned to this rubbish?"

Without waiting for an answer, he shoves the rolled-up leaflet against the woman's nametag, and marches out.  
  


**Notes for the Chapter:**

> First, a note on religion. When writing this, I was aware that whichever religious movement I would have picked the nurse character to represent, some readers belonging to the same might might feel compelled to express the desire to distance themselves from such thinking. Sherlock is not stating that he thinks all Catholics are homophobes; he is angry, and simply making a mental note that religion has likely played a big role in the development of the woman's attitudes towards sexual minorities. The more people within religious groups express and demand tolerance, the brighter future will we have. But, major Christian groups still have a long way to go and a lot to answer for when it comes to issues such as sexual equality and (women's) reproductive rights. Witing a story about discrimination without taking into account the massive impact of religion has had on (the lack of) LGBTQA rights would be kind of a skewed and embellished perspective.
> 
> The CARDS virus is fictional, but it is partly based on the [Middle-Eastern Respiratory Syndrome (MERS) coronavirus](http://www.who.int/en/news-room/fact-sheets/detail/middle-east-respiratory-syndrome-coronavirus-\(mers-cov\)). 
> 
> The [leaflet mentioned in this chapter exists](https://www.nuh.nhs.uk/download.cfm?doc=docm93jijm4n2563.pdf&ver=3807), produced by Nottingham University Hospitals NHS Trust. I am, of course, very much an advocate for making non-discriminatory sexual health and counseling services available for all orientations and all for the public distribution of accurate, neutral support and information regarding safe sex, and I'm sure Sherlock would agree; it's just that this is not the way to go about it... 
> 
> I am in awe of the physical endurance of surgeons whose operations last for hours and hours. Unlike them, the anaesthetist gets to have breaks, and to sit and to move around. The straw trick is a fact and once, the string of a surgeon's scrub trousers was too loose, and those trousers dropped to his ankles. The supervising nurse's job was then to pull them back up.


	2. Chapter 2

 

> "In a city where the most continue to live their lives as though nothing has happened, without even knowing what is going on, young men are falling ill, suffering, withering away and dying. Yes, it is like a war during peacetime."  
>  – Jonas Gardell, " _Döden_ " (" _Death_ ", translated by J. Baillier)

 

John holds his breath and pinches the bridge of his nose as he tries to make sense of what he has just heard on the phone. He goes to close his office door, and calls Sherlock's mobile.

"Are you with a patient?" John asks when he picks up. He wouldn't want Sherlock to interrupt a consultation.

"No, we're just wrapping up today's clinic. Marie's gone to the break room."

"Care to explain why I just got a call from Occupational Health saying you assaulted a nurse _and_ threatened to flash her?"

"That is a very subjective and one-sided interpretation of our conversation. That _hag_ \---" Sherlock spits out the word as though it tastes like ear wax, "is a homophobic relic who ought to be sacked."

"What were you even doing at OH?"

"Humouring Lestrade. _Overdue mandatory check-up_ ," Sherlock replies disdainfully, and John can imagine him making air quotes to accompany the words.

"Tell me exactly how your appointment went, and without creative interpretation, please."

Sherlock recalls his conversation with the nurse; his excellent memory allows him to relay it to John practically verbatim.

"Did it occur to you that she may have just been trying to be nice and act caring after feeling embarrassed by assuming you were straight?" John asks. In John's opinion Sherlock's words to her had not sounded like sexual innuendo but simply something one might say in anger. But, such language is still perfect material to be twisted into a complaint.

There's a silence at the other end.

"So, obviously, it didn't. Yes, her choice of words wasn't very good, but---"

"She thinks we need _counselling for our_ _lifestyle_ ," Sherlock reminds him angrily. "The whole complaint is obviously Greg's fault, for making me go there."

"You don't think there's any point to occupational health, do you? No, of course, you don't," John sighs and rolls his eyes.

"There are many points to occupational health I find useful, but that's assuming the people working there are not lower life forms."

"You're overreacting. As usual."

" _Overreacting_? It's _2015_ , and I get lectured about assumed promiscuity for being gay. You should be on _my_ side – her opinions apply to both of us. Occupational health doesn't get a say in our sex life. Nobody except for us do, and I don't want to discuss it with anyone here."

John is tempted to argue that Sherlock sometimes practically _flaunts_ their sex life when he inadvertently reveals too much about it to their co-workers; he just doesn't always quite get that what happens between the sheets should stay between the sheets. "I'm aware that there's historical baggage to why the things she said are offensive, but I never pegged you for such a gay rights activist."

"It's your baggage, too, even if you're bi and have spent most of your life trying to pass for a straight person."

"That's hardly fair, Sherlock."

"Fair? You think _I'm_ being unfair? The medical establishment is anything but faultless in how it has historically treated minorities. It grates on what little faith I retain in the system to find such archaic attitudes still prevalent."

"You're not wrong, but you still can't threaten to whip out your cock at the OH clinic. It's just not on." Sometimes John thinks he should write a helpful list for Sherlock of things that are _just not on_ , but that list would be long and inevitably Sherlock would come up with plenty of things that aren't on it. "I'll talk to their Ward Sister; she's reasonable. You might have to apologise."

"You can say something nice on my behalf. I'll allow that, but I will _not_ apologise."

"Sherlock, we've talked about this. People appreciate it when the person who has upset them is the one to make amends. Going through a supervisor can be seen as uncaring, as an attempt to conceal that the person isn't really sorry. I shouldn't have to be your apologist."

"I am anything but sorry. I want her to apologise to _me_."

"Not happening. Look, you're not _wrong_ , but you just can't----"

"Spare me the lecture, John."

"I bloody hate lecturing you, I really do, but if you'd just think before you act--- The way you treat people is the way they treat you back."

"I am well aware of that, but it also works the other way around. She was _way_ out of line."

"You have to stop your pre-emptive strikes."

Sherlock looks affronted. "This wasn't a _'pre-emptive strike'_ – she was being nosy and judgmental!"

John sighs. He does agree, but this'll be a huge mess if they have to deal with an official harassment report, and most likely it won't change the woman's convictions. "You're allowed to think that everybody else besides me and Greg are idiots worth less than something scraped off a welly, but it'll only hurt you if you express it. Giving someone the benefit of the doubt is how you'd want yourself to be treated. Everyone makes social blunders sometimes." _Some more often than others._

"People never bother to extend that courtesy to me. As a general rule, they judge me by a single incident, or just disappoint me in other ways. I'm used to it, but sometimes----" his fuming trails out and turns into a sigh. "I lost my temper. It's not as though that doesn't ever happen to you."

"You are smarter than that. You're _better_ than that," John tells him sternly.

"John, you haven't a clue what you're talking about."

"Why?"

"You're not me."

"Here we go again. How does you being you prevent you from _not_ being deliberately mean to someone?"

"I detest that description. She started it."

"You can detest it all you want," John scoffs. "But, there's a fine line between being assertive and being a bully. Even with people you detest it would be easier to get your point across by being civil."

John always tries to avoid using the b-word because he knows what Sherlock has gone through, knows that in the grand tally, he has been bullied more during his childhood than he could ever exact revenge on others during his adult life. But, isn't that long past, now? Why would Sherlock need to continue the same toxic pattern as an adult? It does sound as though the nurse had been judgmental and out of line, but this is not the way to educate her.

"It's better to be feared than it is to be discriminated against and ridiculed," his partner snaps and rings off.

John drops into his chair and blows out a breath. As usual, he'll have to sort this out for Sherlock.  


  
-o-0-o-0-o-0-o-0-o-0-o-

 

Three days later, John is on call. This afternoon he would have been in the car alone, anyway, since Sherlock is attending the neurosurgical unit's late afternoon Mortality & Morbidity meeting. He always grumbles about the days when they don't get off work at the same time, always opting for a taxi instead of the Tube if John isn't driving them, stating that the sounds and smells and too many people in the Underground are way too intense an assault on his nerves. John prefers the car to the Tube as well, but first, he needs to get through this sixteen-hour shift on top of his regular workday.

Well ahead of time, he goes to his locker in the basement dressing room and changes from his suit into scrubs before heading to the OR floor to pick up the on-call phone and a report of the surgeries still ongoing when he gets summoned to A&E. He downs a glass of water in the break room and is just about to go to OR seven to wake up an elective laminectomy that has stretched past office hours, when the phone rings, informing him of a need for an anaesthetist at the A&E department. The other anaesthetist on call – a fellow consultant – tells John that she can oversee what's going on the surgical floor so that John could head down to the Acute bay downstairs.

Unsurprisingly for a late afternoon, the bay is a flurry of activity. Most of the kerfuffle seems to be connected to a thirty-something male – likely homeless judging by the looks of him – who has been brought in by ambulance after passers-by at a Tube station had reported him to the Transport police for behaving oddly. When the police had tried to talk to him, he had become lethargic and incommunicative, eventually collapsing. There's no ID so the staff know nothing about his prior medical history.

The emergency physicians currently overseeing the Acute bay beckons John to join him by the patient's trolley. The patient isn't reacting to monitoring equipment being attached and bloods drawn and isn't opening his eyes or responding to a nurse trying loudly to rouse him.

"GCS 6 – he needs a tube," The ED consultant, Graham Miller, tells John at the end of a brief summary of what they already know.

Emergency physicians usually do their own intubations unless there's an expected difficult airway. The young man's facial anatomy looks quite normal and he's quite thin – emaciated, even. His colour doesn't look good – more ashen grey than healthy peach, but the oxygen saturation with a low-flow Venturi mask still reads 95 %. His hair is matted, badly cut and dirty, and his clothes have seen better days. The filthy, lace-less trainers he's wearing look as though they're about to fall apart.

John opens his mouth to ask why they'd requested an anaesthetist, but the other doctor beats him to it.

"His veins are a disaster zone, and we couldn't get an IV in for the meds. Before going for an intraosseal, we thought we'd ask if you could give a central line a try with ultrasound. I already tried to put in a subclavian with a landmark technique, but either there's a thrombosis or an anatomic anomaly. The guidewire just wouldn't advance."

Miller is an experienced physician; John knows that if he says there's a challenge at hand, the statement is usually always true. "User?"

"Definitely. There are marks even between his toes."

"Right. Any idea if there's a coagulation issue?"

"Unless he's on some meds we have no way of knowing about and which won't show in INR and APTT screens or thrombocyte values, no."

It's good to be on one's guard about such issues, but if a patient really needs a central line and there's no other option, one will be inserted even if their coagulation parameters cannot be quickly fixed or assessed. "What are you suspecting?" John asks, glancing at the monitor again. The patient still seems to be doing somewhat alright with an oxygen mask, but the fact that he's unconscious does warrant intubation due to likely diminished protective airway reflexes. The blood pressure is a bit on the low side but tolerable, heart rate high. Dehydration or an infection – or both – could easily explain such findings.

Miller steps aside when a nurse rolls in the portable ultrasound. "He seemed paranoid and aggressive, was clearly photophobic according to the EMTs and has a fever – this could well be meningitis or encephalitis. The Transport police had noticed that his movements had been ataxic before collapsing, which could point to certain encephalitis types according to the neuro reg on call, but again, the drugs are a confounding factor. Or, this could just be garden-variety sepsis combined with the drugs. We need a head CT and a spinal tap after you're done with the CVC."

"Sure," John confirms. "Do you need me to stay for those?" Usually the ED consultants will gladly do most clinical procedures themselves and are trained to oversee a patient on a respirator.

"No, I'll let you get back upstairs once we have a line in. I can tube him if you're in a hurry, once we get some sedatives in."

John grins. "You know I don't get to shove stuff down people's windpipes often enough nowadays."

Miller laughs and spreads him arms. "All yours, then."

The patient remains unresponsive enough that John decides that no sedatives will be required for the central line insertion; he'd prefer not to risk losing the patient's own breathing and what little protective airway reflexes he retains in his current state. He does request a syringe of lidocaine which he'll use locally in the spot above the clavicle where he's going to try to insert the line, since unconscious patients often retain the ability to feel pain.

While the insertion site on the right side of the patient's neck is being cleaned by a nurse, John watches Miller continue his examination. Pried open with the ED doctor's fingers, the patient's eyes are whipping back and forth in a movement called nystagmus, and there are other signs of cranial nerves not functioning right as well.

"He's had intramuscular flumazenil and naloxone to no effect so, unless he's shot up something more exotic, I don't think it's the drugs doing this," Miller explains. "Besides, there's this," he points out and lifts the patient's worn, filthy sweatshirt.

There are clusters of mole-like, slightly raised‚ purple patches on the skin of the patient's chest. Miller dons a second pair of gloves on top of the ones he's already got – which to John seems odd – and pries open the patient's mouth. Three red, glistening, small, flat tumours similar to the ones on the chest have taken residence in the palate and there are similar but smaller spots in the man's gums. "Sure looks like Kaposi's sarcoma to me," Miller says.

John knows he had been an internal medicine specialist before obtaining a second consultancy in emergency medicine, so he must have seen this skin and mucous membrane malignancy before. John remembers that Kaposis' sarcoma at least used to be one of the criteria used to determine when the AIDS phase of HIV infection has begun. _The double gloves._. Not that they're really necessary. "You reckon he might be HIV positive, then?" John suggests. "Undiagnosed before this?"

"Could just be that he's homeless with mental problems and hasn't adhered to treatment, but yeah, that's definitely a possibility. I can't come up with any other skin lesions that look like this."

HIV treatment is free for all UK residents, so obtaining the medications is not a money issue. Most HIV-positive individuals take decades to develop AIDS or never do, since the modern antiretroviral medications can mostly prevent that altogether. It's now exceedingly rare to see a patient who comes in with fulminant, terminal disease.

John dons a sterile gown and gloves and lines the procedure area with three rectangular, adhesive-lined sterile drapes. In goes the lidocaine. Then, with the help of a nurse, he slips the ultrasound probe into a sterile bag.

A glance at the vitals monitor shows that the patient is still relatively stable, though John doesn't like the worsening sinus tachycardia. "Did you get blood gases already?" he asks Miller from behind his mask.

"Yeah, from the femoral artery. CO2 was five point five."

The results confirm that the patient has been breathing quite adequately on his own. His airway still needs to be secured to protect his lungs from stomach contents and to monitor his respiratory functions. For that, he needs this intravenous route for drugs. John doesn't ask the patient's head to be tilted below their feet – while it would make it easier to find the vein since it would be congested with blood, it would raise intracranial pressure which might already be at a dangerous level depending on the cause of the state their John Doe is in and whether there's something acutely wrong with his brain.

With the help of the ultrasound, John finds the internal jugular vein, and after puncturing it with a needle, manages to slide in the guidewire deep enough. One more sweep of the ultrasound probe confirms that it is inside the vein and directed towards the superior vena cava. After threading in the central line itself and flushing it with saline, John jabs a bit more lidocaine under the patient's skin to numb the spots where he'll secure the line to the skin with sutures. After he's tied the first knot, one of the loose threads of it gets tangled underneath a plastic clip that attaches the sutures around the central line, so John grabs the much larger introducer needle again and uses the tip to wiggle the thread out.

Just as he's about to put the needle back on the instrument table, the patient jerks violently as he begins to seize, and the toothpick-thick needle gets plunged into the middle of his right palm.

"Fuck," he gasps and steps instinctively back as two nurses and Miller rip the sterile drapes off and begin addressing what looks to be a classic tonic-clonic Grand mal seizure.

John tears off his gloves, muttering more curses under his breath, cold sweat prickling in his neck. There's no point in checking the glove to see if it has been pierced – he knows it has, since he'd felt the needle sink at least a few millimetres into his palm. The spot is throbbing, and there's blood seeping out of the puncture wound.

Fear kicks in properly: _I'll lose my job_. The NHS policy regarding HIV-positive employees is among the strictest in Europe. Infected employees are not allowed to do work where they'll need to perform procedures deemed to be of high risk, even though less than five cases of healthcare workers infecting patients have been reported globally. John isn't sure how the policy treats anaesthetists, and he certainly doesn't want to know or become the first case to be dealt with. There have been talks about changing the policy, since treated HIV is now a chronic illness and not a death sentence, and the risk of a patient contracting it from a physician is very, very marginal, but new guidelines haven't been announced yet. One of the biggest problems of the current policy is that it instils a culture of fear, preventing healthcare employees from seeking testing and obtaining the treatment they need.

He pulls off his sterile gown and drops it on the floor while hurrying to a nearby sink.

"John?" Miller asks as he empties a small syringe of milky substance – likely diazepam – into the central line to try to stop the seizure.

"I stuck myself," John admits, and starts running water across his palm.

Miller nods with a sympathetic grimace and shoves a pillow between the patient's head and the metal railing of the trolley.

John pumps out some soap and washes the small, bleeding wound, then douses his palm with the strongest antiseptic solution he can find on a nearby cleaner's cart. It stings, and his hand is still bleeding, so he shoves it under the faucet again, watching the swirls of read disappear down the drain. He doesn't want to stop the bleeding – instead, he desperately hopes that the viruses which may have gotten into his circulation might leave the way they'd came if he bleeds enough. It's irrational, but he can't bring himself to stop hoping.

The patient's seizure finally abates. "I'd suggest pentothal for the intubation," John says distractedly.

Miller hums in agreement. A nurse goes to fetch the aforementioned antiepileptic barbiturate also used as a general anaesthetic.

"Rocuronium, pentothal, ephedrine and fentanyl, please Suzanne," Miller requests and shoves the airway cart next to the patient's bed. "Did it puncture through, John?"

"Yeah, and then some."

"We'll get the HIV quick screen done as well as the regular ones and a Hep screen. There's no way to get consent, and we don't know who his next of kin is, but we need to test him anyway for differential diagnostics. You need your day zero samples taken as well, John."

"I'll call the lab," Suzanne says as she brings Miller the drugs he'd requested. "D'you reckon we need to get him on retroviral prophylaxis?" she asks the emergency physician, nodding towards John.

Miller's expression is grim. "You saw what I saw. There are enough risk factors here to warrant it."

Suzanne grabs a packet of sterile gauze, opens it and shoves the contents into John's hand.

He presses it against the palm which isn't really bleeding anymore; the cold water seems to have done the trick. He watches as his colleague intubates the patient and hooks him up to a ventilator. There's no need for him here, now, but he feels rattled and wants a moment for himself, so he retreats to sit on a saddle stool in a corner.

Had he really just plunged a hollow needle probably teeming with the human immunodeficiency virus into where the microbe could easily get into his bloodstream? He lists the risk factors in his head: hollow needle, deep tissue injury, patient likely HIV positive and untreated, meaning that they might be highly infective; certainty of the needle having been in contact with blood, a bleeding injury. _This ticks all the bloody boxes!_

He's embarrassed. He should never have picked up that needle again. He should have let the thread be. _Fucking idiot_.

Suzanne walks up to him, and it takes her two tries of calling his name to get him to look up. "Go to the triage desk and tell Louis what happened, he'll sort you out with the prophylaxis since it should be started as soon as possible; you need to get in touch with Occupational Health in the morning since we can only give you the meds for a few days."

"Are you alright handling things here?" John asks, leaning past Suzanne to glance at Miller. He still feels responsible for the patient, though he doesn't seem to be able to concentrate very well right now. Miller's good at what he does, he shouldn't have any problem taking over from here. Yet, John feels apprehensive.

"We're fine. Go," Miller prompts.

John leaves the Acute bay to find Louis, one of the staff nurses who often works at triage and pulls him aside. He shows his palm, around which he'd haphazardly pressed some hand towels on top of the gauze and explains – through gritted teeth – what had happened.

To his relief, Louis doesn't ask him any further questions, simply stands up from behind his desk and instructs John to follow him.

This isn't John's first needle-stick injury. He'd once cut his thumb with a scalpel during Foundation training, and once he'd pricked his wrist with a used IV cannula. There have also been several tiny nicks which have barely punctured his glove which he hadn't even reported because he hates the song and dance things always kicks off with HR and Occupational Health. He knows he should have reported every incident, but... This time, he will certainly want to jump through the hoops properly.

Louis takes him to a back room, opens a metal cabinet with his massive set of keys and after rummaging around, shoves two small cardboard packets into John's hands. "The directions have been put in the boxes. Truvada's one tablet twice a day, Kaletra's two tablets twice a day. You take them until OH tells you to stop. They usually give you a prescription for cyclizine and loperamide as well, for the side effects."

John hadn't even thought of side effects. He skims what's written on the packages; both medications are combinations of two drugs – no wonder they might mess with his system.

"Read the package inserts for contraindications," Louis reminds him in the tone of someone who's done this speech a hundred times. "Did they get your samples?"

"One of the nurses promised to call the lab."

"You could just go there and tell them what you told me. I'll type in the request for from the reception desk, so it should be ready by the time you get to the third floor."

John shoves the cardboard packets into his scrub trouser pockets. They barely fit. "Thanks."

"Shit happens. Don't worry about it."

John almost laughs. He feels a little hysterical and oddly calm at the same time.

While walking out of A&E into the empty connecting corridor between two wings of the hospital, he calls the other anaesthesia consultant to tell her he'll be unavailable for about half an hour.

He doesn't tell her where he's going, or why. He _knows_ this happens to everyone sometimes, but embarrassment is still reigning in his head. He'll go to the lab, then get back to his duties. He has to. This is no reason to shirk his on-call duties. It's just a needle stick. It happens.

When he reaches out to press the lift button, his hand is shaking.  
  
  


**Notes for the Chapter:**

> This story happens a few years back, when the old NHS policy was still in effect. Since then, it has, thankfully, been overturned. Reports on this: <https://www.theguardian.com/lifeandstyle/2013/aug/18/nhs-guidelines-doctors-nurses-hiv>, <https://www.telegraph.co.uk/news/health/news/10242927/Ban-on-doctors-with-HIV-lifted.html>. The policy used to be very strict compared with most other European countries and came with problems such as avoidance of testing and thus delay of treatment. Imagine fearing both getting infected and losing or at least having to change jobs as a result! There used to be [mandatory HIV testing for employees](https://www.theguardian.com/society/2003/jan/02/nhsstaff.health) in NHS whose job descriptions were deemed to be particularly risky. Singling out NHS employees like this merely enforced frightening stereotypes about HIV amongst the general public instead of actually improving patient safety much; if anything, it motivated employees to hide their infection or avoid testing and perhaps even delay treatment, which would have made their viral loads higher. A healthcare employee under proper treatment for HIV is not a significant enough risk to patients to warrant limitations, regardless of specialty.
> 
> Needle stick injuries are common – and upsetting – because while the risk is small, it still exists. I've been there – probably every anaesthetist and surgeon has had it happen to them at some point. In most countries and cases, we must ask for the patient's permission to test them after a needle stick, unless there is a legitimate diagnostic reason to take the HIV and hepatitis tests, anyway. In the case described here that reason very much exists. The only sensible way in which to deal with the issue of potentially infectious patients as a healthcare employee is to treat every patient as though they could carry a blood-borne pathogen – not overreact, but not take unnecessary risks, either. What protects a doctor or nurse well enough from getting infected by a patient also works the other way around.


	3. Chapter 3

 

> _"About the only sporting proposition that remains unimpaired by the relentless domestication of a once free-living human species is the war against those ferocious little fellow creatures, which lurk in dark corners and stalk us in the bodies of rats, mice and all kinds of domestic animals; which fly and crawl with the insects, and waylay us in our food and drink and even in our love."_  
>  – Hans Zinsser, an American physician, poet, and bacteriologist

 

  
In the morning, after a few hours of restless tossing and turning in the call room, John is forced to wrench himself out of bed because his stomach starts cramping and he's on the verge of throwing up.

 _They weren't kidding about the side-effects_ , he curses inwardly while fumbling around for the light switch in the small en suite. Nothing comes up, and the cramps are not moving anything forward, so he ends up just emptying his bladder. After flushing the toilet, he grabs a packet of fresh gauze from the stash the lab phlebotomist had given him after seeing the paper towels around his palm. Peering under the old gauze he sees that the wound hasn't been bleeding, but there's a tiny dog-ear of skin in the small puncture.

Right now, with his stomach churning and nausea still pushing cold sweat out of his pores, John is tempted not to take more of the antiretrovirals. Still, while the general risk of infection from a needle-stick injury involving HIV-contaminated blood is only 0.3%, it is still _not a zero_ , and it's the not being sure that's the worst thing. Besides, that statistic has been based on a large pool of occupational exposure data, and most of those patients likely had viral loads much, much lighter than their John Doe.

John realises that he doesn't know where to ask about the patient's test results; he must have been transferred up to one of the Critical Care units since they'd had to intubate. Occupational Health will probably follow all that up. John calls the OH clinic from the call room, jots down a few notes regarding the instructions he gets, and promises to pick up a follow-up prescription the next day. He can buy anti-nausea medication over the counter today, if need be.

He drops down to lie on the bed for a few moments more. The clock has already hit 8am, marking the end of his call shift, but the stomach ache is making him feel lethargic and he worries about having to make a toilet stop on his drive home. He hasn't felt this tired after a call shift after Foundation training.

On his way upstairs, he buys a juice box from the staff canteen which feels as though it's scorching the bottom of his oesophagus; having a morning coffee is the last thing he wants right now. He makes his way to the OR unit to drop off his call phone; there's nothing he needs to report to the day crew so it's a quick stop before heading to the locker room in the basement. Once there, he's so tired and distracted that he walks right past Sherlock who's changing into scrubs. Only when he calls out to John does he turn and realise who's there.

"Running late?" John asks him. It's well past eight in the morning, and officially Sherlock's working hours start at 7:30.

"I have half a day of outpatient clinic to make up for the conference last week, then a glioblastoma resection."

That explains why he isn't already scrubbing in – his outpatient clinic always starts at 9am, allowing him to have a slower morning, perhaps a cup of coffee together in the cafeteria if John has an admin day.

Sherlock watches him, leaning against the edge of the row of metal lockers, while John strips off his sweaty scrubs and drops them into a laundry bin.

"What's wrong?" Sherlock eventually asks, his eyes narrowed and entire being honed in on John as his formidable brain kicks into high gear to deduce why John is behaving strangely in some subtle way no one else would even be able to pick up on.

John rubs his closed eyelids with his fingertips, then raises his gauze-wrapped palm for Sherlock to see. "Fucking stick injury. I'm on antiretrovirals now." He puts on his trousers and an undershirt and slumps down to sit on the bench in front of the lockers, running a hand through his greasy hair. He doubts he'll have the energy to shower once he gets home.

A shower wouldn't stop him from feeling tainted, anyway. _Infected. Contaminated._ It's all in his head and being tired makes the paranoia worse. It's all dragging his mood down in the dumps.

"Why? Is the patient a known carrier of something?"

"No, but he might be undiagnosed and highly infectious. It's a John Doe. Miller thinks he's got Kaposi's sarcoma." Sherlock will be aware of the implications of this.

"I'm sorry," Sherlock offers. "We have all been there, although my exposures have always been low-risk and I can't recall on ever operating on someone with an advanced HIV infection."

"That you know of."

"I do often order a more thorough blood workup for my patients than anaesthesia have suggested."

In John's current mood, the remark sounds a bit superior. "Good on you."

"The prophylaxis is supposed to be very effective. How soon did you take the first dose?"

"Less than thirty minutes. It's also going to be condoms for us for fuck knows how long."

Sherlock shoves himself away from the locker and walks up to John, who's pulling his navy blue cardigan down over his head.

"We'll manage," Sherlock offers.

"Well thank you, Mister Accommodating," John snaps, "We'll see how much sex I'll be wanting to have while going through every bloody antiretroviral side-effect in the book." He's tired, his bowels feel like they have tied themselves in knots, he has a headache, and his legs are itchy.

Sherlock is frowning as he moves closer to John. A hesitant hand slithers onto John's opposite shoulder and pulls him into am embrace. John circles his arms around his waist for a brief hug before digging his coat out of his locker.

He must truly look and sound a mess if Sherlock has come up with the idea that he needs to be consoled.

_It's just a stupid needle stick. Get over it. It happens. The prophylaxis is effective._

"What does the follow-up entail?" Sherlock asks.

 _Always a man of data and science._ "OH will see me weekly; kidney and liver function tests and FBC need to be repeated just as often. I'll need to take the meds for a month, assuming the patient's HIV screen comes back positive."

"The rapid test is just as accurate nowadays as the regular lab work. You'll know soon," Sherlock points out.

It doesn't console John, because the likelihood of a result that says he hasn't been exposed seems low. He could have phoned A&E to ask for the rapid test result, but it won't change what he needs to do, and he's not in the mood to have his worries confirmed.

"I'm going home," he tells Sherlock needlessly. He's bloody thankful that there aren't any administrative duties today which would require him to linger at the hospital after such a shit night.

"Obviously."

John heads for the door, sighing as he pushes past Sherlock, who calls out his name again as he grips the door handle. "Yeah?"

"Do you... need anything?"

"There's nothing that isn't already being done. A time machine would be nice, though." John lets the door swing close after him.

During the drive home, he gets a call from OH: the patient's rapid test has, indeed, come back positive.

_Big fucking surprise._

-o-0-o-0-o-0-o-0-o-0-o-0-o-

 

Apparently, it's possible to have diarrhoea and constipation at the same time. _Who knew._

John is also looking forward to finding out whether the antiretrovirals manage to fry both his kidneys _and_ his liver in a month. On top of the gastrointestinal distress, he's also having pins and needles in his toes, trouble falling asleep and slight difficulties in reading from a screen. The itching continues and apparently, that might be a feature that lasts longer than most side effects.

"At least you can't get menstrual cycle changes," Sherlock points out to him three days later, while reading the medication packet inserts over tea.

John isn't so sure about that – the constant lower stomach cramps are certainly making him feel like a sudden uterus might well have sprouted into existence. If this is what his female colleagues have to go through once a month, he’s going to revise upward his opinion about their endurance and stoicism.

At least there's some good news: a CARDS vaccine is being tested in Moldova, and the case in France has remained a singular incident. The prediction seems to be accurate that the virus is burning through its patient population so fast that a pandemic may, oddly enough, be as unlikely as it had been with Ebola. The various petitions by A&E staff with which admin has been bombarded have become fewer after the higher-ups had agreed to blowthe A&E budget with protective gear acquisitions. The Ministry of Health still hasn't chipped in since they have classed the threat as negligible. Maybe this will fizzle out like Ebola. However, John isn't naive enough to think there won't be more emerging epidemics like this in the future.

  
-o-0-o-0-o-0-o-0-o-0-o-0-o-

 

  
Two days later, Sherlock knocks on the toilet door while John continues retching and glancing at his watch. They should have left for work already, but if he takes the prophylaxis tablets on an empty stomach, they come up, and as long as he throws up, he can't eat. To add insult to injury, the pills have decimated his appetite.

 _How the hell do people work and get on with their lives for years and years while on this stuff?_ he wonders. Granted, he hasn't been on the medications for very long, but the doctor he'd talked to at OH had told him that, unfortunately, many of the side effects do linger. At least some of the ones won't even have time to kick in such as the localisation of body fat changing.

 _It's just a month_.

Sherlock knocks again. "John?"

"Use the other bathroom!" John yells through the door.

"I'm ready to leave, whereas you're not. You should call in sick."

"I'm not contagious," John replies angrily through the closed door and rises from the floor to open the tap to rinse his mouth. Lifting his head from the sink makes him momentarily dizzy, and the  churning stomach pain is kicking up a notch again.

He can't call in sick. He has paperwork reaching up to the ceiling. And, if he misses a University Co-Operative Board meeting in the morning, it'll look terrible for the Trust.

He emerges from the toilet and nearly walks into Sherlock who had been waiting for him in the hallway.

"Do you mind if we get a cab? I don't feel like driving."

Sherlock takes a long look at him, concern evident on his face. He opens his mouth, presumably to protest yet again that John shouldn't be going in at all, then snaps it shut. Maybe, this once, he has realised that it would be very pot-kettle to lecture John about going to work when feeling under the weather; after all, a few months ago Sherlock had tried to insist he would continue working with his skull wired into a halo rig.

 

-o-0-o-0-o-0-o-0-o-0-o-

  
During the next few days, the uproar about CARDS winds down completely after the expensive delivery of a veritable stockpile of protective equipment is delivered to A&E, new guidelines arrive in thick folders from the Ministry of Health, and the singular French patient recovers and is released from hospital.

On Wednesday afternoon, John decides to address what he has been putting off: resolving Sherlock's Occupational Health incident. At first, he drafts an email addressed to the head of the OH unit, the nurse in question, the Trust's Equality & Diversity Liaison, and a blind carbon copy to Sherlock. He keeps it neutral and refrains from mentioning their relationship; it mostly just contains a diplomatic summary of the incident and a prompt to ensure that NHS's anti-discrimination guidelines are embraced in Occupational Health services. It should be enough to make the point that Sherlock had not been the firestarter.

But, just as John is about to hit _send_ , a memory from several years back makes him hesitate.

During the early stages of their relationship, just after they'd moved in together, Sherlock had begun to think that John was trying to conceal their relationship from their co-workers because he was embarrassed by it. It's too late trying to avoid making this personal on both their behalf – the nurse had already done that. He should make a stand and being Sherlock's partner is not a reason to avoid getting involved – it's the _opposite_. If the nurse had behaved the way she did at a unit handling patients who are not healthcare professionals, the incident might have even ended up in the media. If Gay Joe Bloggs shouldn't and wouldn't put up with such behaviour, why should someone working in the system be more lenient?

John reopens the message draft. To the list of recipients, he adds a member of the Board of Directors he knows has a same-sex partner, the head of PR for the trust, and shifts Sherlock to one of the recipients visible to everyone. Then, he adds a few lines at the end of the message:

 _'Me and my partner are both appreciative of proactivity in educating patients about sexual health, but the suggestion that non-heterosexual orientation requires counselling and is associated with risk behaviour even in a stable relationship is, in my opinion, in clear violation of the Trust's anti-discrimination policy (see document attached) and,_ _if not the word, then certainly the spirit of the NHS guideline publication_ " _Sexual orientation – a practical guide_ " _(PDF attached). I expect the administration of the Trust's OH unit to assess the need for diversity training for its staff.'_

He clicks 'send', then leans back in his chair to close his eyes for a moment before heading to the cafeteria to grab a coffee. He is away from his office no more than fifteen minutes, but in that time two replies have already arrived. One is from the Diversity Liaison, a short communique informing everyone on the recipient list that the incident will be promptly investigated further. The other reply is from the head of the OH unit; addressed only to John, it says that this is not the first complaint made against the nurse; a prior one had been about the way she had treated a registrar who had had an abortion. The unit head also mentions that he will look into what had happened, and likely issue an official warning.

At five in the afternoon, he gets a rather enthusiastic kiss after Sherlock slides into the shotgun seat of their car. Usually he's still too preoccupied with the day's work during the ride home that he largely ignores John.

"What was that for?" John asks with a chuckle.

"Don't tell me you're too daft to deduce it," Sherlock replies and starts stabbing away at his tablet with his forefinger.

John grins and puts the car in reverse.

  
-o-0-o-0-o-0-o-0-o-0-o-

 

Apart from the retrovirals continuing to make him feel like a dishrag wrung dry, the rest of the week goes rather smoothly for John, until Friday afternoon arrives. John had thought that he'd put out all the proverbial fires for a while, but now a new – once again contagion-related – problem pops up. Greg tells John it's business as usual that these sorts of things come up every once in a while, but even he looks a little spooked when the two of them are summoned to a meeting in the litigation department – Bloodsuckershire, as Greg calls the legal section of admin. The hospital is being threatened with a court case, and this meeting will be their last chance to negotiate. Since there's strength in numbers and John is, after all, the Director of Operative Services and this is a surgical complication, he could hardly have said no when Greg had asked for backup. The senior neurosurgeon has met up with the family once before, but the patient himself hadn't been in a state fit to discuss things at that time. His wife had been livid.

Courteous good mornings are exchanged between John, Greg, two of the Trust's lawyers, the patient, his wife and adult daughter, their barrister, the Acting Director of the hospital, and a patient rights liaison.

The Director is chairing the meeting. "Mister Lestrade, if you would be so kind as to go over the main points."

The three barristers hone their gazes on Greg.

"On the twelfth of March, Mister Langham came in for an elective removal of a meningeoma – that's a benign tumour inside the skull. The surgery was carried out by me and went according to plan. Mister Langham has no significant prior history of health issues; the tumour was discovered when he began noticing vision changes; the meningeoma was pressing on his left optic nerve. It was clearly demarcated, and the removal was complete."

"Would you agree, Mister Langham, that this is a truthful account of the events?" the patient's barrister cuts in.

The man nods. "Yes. That's what they told me, anyway."

Greg clears his throat. "Regrettably, I was away for a conference when Mister Langham began exhibiting symptoms of his surgical incision becoming infected. This was during the last days of his stay at the neurosurgical ward."

Greg and John had gone through the records and Greg had breathed a sigh of relief when no notes or lab results pointed to a brewing infection prior to him flying out to Barcelona. Another consultant had been overseeing the registrars' work at the ward, and as far and John could tell, the infection had been picked up and addressed promptly during Greg's absence.

But, that isn't the issue here.

One of the hospital's barristers asks: "Did the infection resolve? How are you doing now, Mister Langham?" He is artfully cutting down to what they probably think is the Trust's main argument: the outcome looks good, since the patient is sitting here being very functional.

The wife pipes in: "He's alright _now_ , but we lost so much business, and this just isn't acceptable! Don't sit there pretending this isn't a scandal, such things happening on _your_ ward! These are people who brains have been operated on, what if the infection gets deep enough to get in _there_?"

"Mister and Mrs Langham own a window glazing business, and they have no insurance to cover for the level of revenue loss as was caused by the MRSA. We are seeking compensation for both the excessive suffering caused by such a complication, and for its economic implications," the family's barrister explains.

Greg leans back in his chair. "Intracranial surgery always carries risks. There could have been another type of complication that would have extended Mister Langham's recovery time in a very similar manner."

The hospital barristers look pleased. The patient's barrister looks like he has just sucked on a lemon.

"You have bloody MRSA in your hospital! That's not the same, it's not the same at all!" The patient's wife complains, glaring daggers at Greg.

"We have tested all the staff at the ward, and no patient who had been in the same room during or close to Mister Langham's stay has given a positive sample." John refrains from mentioning that the tests are not fool-proof, and that not all patients are even screened. MRSA can even be carried asymptomatically – anyone could have it without knowing, and it tends to only cause serious infections when a patient's immune system is compromised, or if they have an injury or a surgical incision.

"Meticulous swab samples have also been taken from both the OR in which Mister Langham was operated in, and the patient rooms and common areas of the ward. It is not accurate to say that we _have MRSA on our ward_ , because we could not locate a source for the infection. It could be anyone," John explains.

"Next, you'll be trying to blame _us_ , judging by the way this is going," the wife snaps.

John refrains from adding that yes, even a family member could be an asymptomatic carrier. "We're not blaming anyone until a court of law does," John reminds the wife, trying to sound as diplomatic as he can. "There is no way of knowing where the infection came from, so negligence cannot be proven."

"It must be still here! He can't be the only case you've had. I've read the papers; those resistant bacteria are everywhere in the NHS!"

"One in thirty people carry MRSA, Mrs Langham. We cannot test everyone who walks in the door. What would we do with those who test positive?"

"Can't you treat it?"

"It might go away on its own, and there's an eradication treatment that is time-consuming and complicated. And it may not work. And, such antibiotic treatment can have side effects."

"They can't be hiding the results, can they?" The wife asks their barrister; "What if they know who gave it to Peter, but they just won't say?"

"If this goes to court, that would be disastrous for them. I doubt they'd be _that_ stupid," their barrister comments, eyeing up his adversaries across the table.

John leans forward. He's sitting across from Mister Langham, who seems to be dominated by his wife. "Mister Langham, I am terribly sorry this happened to you. I assure you we have done everything we can to ensure there is no source of infection present in our facilities, and the infection you developed was caught early. I know it's not much consolation, but this may just be a case of bad luck."

The hospital director shuffles his papers. "As a sign of goodwill, we are willing to negotiate restitution for ten days of lost average revenue with the proviso that no further claims of negligent conduct will be made."

John glances at Greg, who looks tense. This is the moment of truth. It has become obvious that the wife isn't going to relent until this goes to court, or some other mitigating gesture is offered. This is the most that the legal department is willing to offer, and they had made it clear that it needs to be called _a gesture of goodwill_ , not an admission of guilt.

"That's... good, isn't it?" Mister Langham asks his wife. "We could lose in court. Prosecuting would cost a lot."

"May we have a moment?" Their barrister asks, and the rest of the attendees file out of the room.

John and Greg grab a cup of lukewarm coffee from a side table in the corridor; a thermos has been left there likely by the participants of some early morning meeting.

"It's a losing battle," Greg scoffs. "In ten years, mark my words, we won't be even testing for this crap because it'll be everywhere. It probably already is. If people didn't demand antibiotics for every bloody viral flu, we wouldn't be neck deep in this resistant shit," he curses, repeating a statement he'd made several times to John while they were spending a long evening going through Mister Langham's patient records.

Having heard his words, the hospital's older barrister gives them a disapproving glance and Greg defiantly stares the man right back for a moment.

John sips his coffee, then realises what it's probably going to do to the now constant heartburn he's suffering from.

Greg isn't done with blowing off steam just yet: "I heard that the private maternity unit at Maitland is considering declining clients from outside Europe. They used to get a lot of business from India but now they're seeing so much VRE and ESBL in those patients that they're dead afraid it'll contaminate the whole damned place."

"British travellers can get it, too, so that solves nothing," John points out. Most of the asymptomatic ESBL carriers he has seen at the King's maternity ward – on the rare occasions when he helps out there while on call – have been young Britons who'd gone to Goa before getting pregnant.

The meeting room door opens, and the patient's barrister gives them all a calm, collected smile. "We're ready for you."

They flock back into the meeting room; John donks his scrunched-up disposable coffee cup into a bin under the table.

"We've decided to accept the offer," the barrister announces. John quickly glances at Greg, who relaxes a fraction. This would have been his department under fire.

"You have enough money to get the best bloody barristers. Never mind what actually happened, you lot would have won anyway," the wife accuses. "We just can't afford that."

"I, for one, am glad that this could be resolved today," the Hospital Director says, and starts packing his briefcase. He stands up, leans across the table, and shakes Mister Langham's hand. The wife crosses her arms angrily.

Greg and John offer a handshake to the patient as well. "I am sorry for your troubles," Greg says.

"Thank you," Mister Langham replies tentatively. "At least the tumour's out."

As much as John had been hoping that they could protect the hospital and avoid a court case, he does understand the family's attitude, even if the wife has been a tad annoying in her abrasive conduct. Mister Langham had come in for a routine operation but got hit with a resistant strain of bacteria that could have infiltrated deeper into his meningeal tissues or even his brain. Who wouldn't be angry after that? Nobody assumes they'll get a complication, and statistics don't console those who are hit by whatever those statistics are claiming is rare.

John's stomach twists again; he should eat something but has no desire to do so. Walking to the lifts, he realises how much he actually sympathises with Mister Langham. They have both landed themselves under threat of a serious infection just because they've spent time in this bloody hospital.

 

-o-0-o-0-o-0-o-0-o-0-o-0-o-

 

"Alright if I switch off the light?" John asks.

Sherlock's reply is to slip a bookmark into the medical journal he'd been reading and shove it onto his bedside cabinet.

Before John manages to find the cord of the lamp on his bedside table, Sherlock has leaned over him, descending for a goodnight kiss. Instinctively, John leans away, leaving his partner blinking and bewildered and clearly a little hurt. He tries to hide it but it's too late; that slightly shocked, mildly pouty look John recognises well has already taken over.

Sherlock returns to his own side and sits up, glaring at John. "Is this about the needle stick?"

John drops his hand from the cord he has now located, letting the light remain on. He looks away, biting his lip. "I guess," he admits.

"If I was in your position, would you kiss me?"

"Yeah, I would," John answers instantly and honestly. He reminds himself, once again, that the prophylaxis is effective, and the risk of transmission through kissing is marginal even for someone with untreated HIV.

But  _still_. Their positions are _not_ reversed. For him, the damage could already be done, and he'd never forgive himself for endangering Sherlock's health and potentially condemning his career as well. He _knows_ his thinking is irrational and paranoid, and it's even not so much a thought as it is a vague sense of anxiety.

"Any one of the people you have kissed during your extensive career as a womaniser could have carried the virus," Sherlock points out.

"I  _know_." On a rational level, John knows all of this – knows it well – but he's still worried and embarrassed enough not to want to risk further disaster. "A _womaniser_?" He snorts.

"People living with HIV even have _sex_ , John."

"I know!" John snaps. He wouldn't be one of those people, even in this most likely uninfected limbo state. If he does get infected, would he be able to ever make love to Sherlock again? He _knows_ the risk can be contained, he _knows_ how to use a condom, he _knows_ that people with HIV manage fine, and that nowadays they live a long life and usually die of the same stuff healthy people eventually die of, instead of developing the end-stage of the infection. But, it would still be a big deal – a life-changing deal. He might lose his job since it entails lots of blood exposure risk procedures, unless the NHS was willing to just bury him under a mound of admin. Is a doctor who isn't allowed to touch a single patient really a proper NHS doctor, if clinical patient work is what they really want to do?

During medical school, John had attended a talk by two volunteers from a local HIV support group. One of them, a fifty-something straight man who had been infected after a drunken night with a prostitute had eventually divorced his wife – not because she wouldn't forgive the one-night stand, but because their relationship suffered since he couldn't bring himself to have sex with her anymore for fear of transmission. The speaker had recounted his experiences of dating another HIV positive person after the divorce; since their virus strains were not the same and there are theories that a double infection could speed up the disease or render medications ineffective, that relationship had broken up out of fear, too.

"It's not just your decision," Sherlock insists. "If you get it – and statistics dictate that _you won't_ ––"

"Sherlock---" John really, _really_ doesn't want to continue discussing this.

"If you get it, and you pass it on to me, it will have happened because I weighed on the balance of probabilities and decided that the small risk was acceptable in order to allow our relationship to remain in its current, highly satisfactory state – with the addition of high-quality condoms, of course."

John stares at him. "You're amazing. You know that, right? You're just so---" _Rational. Capable of seeing through bullshit brought on by fear and doubt._  

Sherlock raises a sly brow. "I'm what?"

"You're just so _you_."

Now, John _does_ very much feel like kissing him, and he goes for it, scooting all the way to Sherlock's side to press himself on top of him, slowly slithering his fingers between Sherlock's head and his pillow and tugging at the curls just _so_. There's a content, distracted sigh from Sherlock as a result. John has long suspected that he likes a bit of hair pulling, and when he'd needed to help Sherlock sort out his hair during the halo vest treatment, he had learned that Sherlock probably likes anything and everything done to his scalp and curls.

Normally, this could easily have led to more, but after giving Sherlock's left earlobe a lick which John knows will leave his partner deliciously frustrated, he returns to his side of the bed. The rational, wonderful things Sherlock has just told him and reminded him of have helped John at least momentarily shove aside his worries.

 

-o-0-o-0-o-0-o-0-o-0-o-

  
The next day, after bringing in some papers for Lestrade to sign regarding a conference expense report, Sherlock wanders into John's office and snatches a piece of paper from the desk. "Are these the final lab results from your exposure patient's first samples?"

John can see he's holding the second page of the copy of the lab printout which doesn't contain the patient's ID. "Yeah. Meant to put them in the shredder pile. It says the same as the rapid test; he's teeming with the virus. Hep screens were negative, but that hardly improves his prognosis."

Sherlock is crunching up his nose thoughtfully at the immunology panel. "What's his status now?"

"As you can see, his CD4 count is disastrously low, and he's still unconscious at the ITU with what's most likely Cytomegalovirus encephalitis. He's also got some sort of an atypical Mycobacterium pneumonia. They don't think he has a chance to make it through – Hyong doesn't think he'll survive the week. At least they finally found out who the guy is – turns out he's the son of an MP. Estranged, probably, since nothing about him being homeless or on the sauce has been in the papers." John had googled the name out of idle curiosity. Very few mentions of even the MPs wife have appeared in the media; the man's reputation seems to be squeaky clean, and all his communications with the press work-related.

Sherlock grabs the other sheet of paper from the desk to see the patient's name. He's quiet for a moment, frown lines deepening on his forehead. "Has he had visitors?" he finally asks, tone suddenly hesitant.

John shrugs. "I wouldn't know." Why would Sherlock even care? Sometimes his attempts to try to convince John he is interested in the minutiae of his life or his worries are rather transparent.

Sherlock carefully places the lab printout back on John's desk and heads for the elevator without another word.  
  


**Notes for the Chapter:**

> The NHS practical guide [exists](http://webarchive.nationalarchives.gov.uk/20130123195750/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_095634).


	4. Chapter 4

 

> **"My son. You have written to me again. I have begged you not to do so and I must beg that of you again. You have to understand. I love you. I hope you are well. But, I pretend you do not exist."**  
>  – Jonas Gardell, " _Sjukdomen_ " (" _The_ _Illness_ ", translated by J. Baillier)

  


After stopping by at the OH clinic to renew his anti-nausea medication prescription and to have some blood drawn for monitoring his liver and kidney function, John heads to the Jack Steinberg Critical Care Unit. He needs to talk to the unit's chief physician about cancelled elective cardiac surgeries due to spots for new patients not being available in the required quantities. He knows that part of the problem is that the wards and the Cardiac Care Units are not able to take in patients fast enough from the ITU, but unless he wants to piss off the coronary care people by making them suspect they are being scapegoated, he'll need to tighten the reins with King's College's adult critical care units as well.

He's just turned to the corridor leading from the main hallway to the ITU's main entrance when the electronic doors open, and Sherlock walks out. This isn't unusual – many neurosurgical patients require post-operative care there. But, his expression catches John by surprise. He's walking fast and looks distracted to the point of distressed. Without noticing John, he briskly cuts a corner to an empty maintenance hallway which John knows is a cul-de-sac. Why ever would he go there?

John stops at the start of that short corridor. Sherlock hasn't noticed him; he is standing at the end of the hall with his back pressed against the wall facing a fire escape. Closing his eyes tightly together, he steeples his fingers together into his usual thinking stance, but instead of perching his chin on his fingertips, he covers his nose and mouth, breathing heavily, as though desperately battling the onslaught of shock. John's eyes go wide when a tear squeezes past his eyelashes which are now pressed tightly against his cheeks. Sherlock then swipes at his eyes with the side of his palm, exhaling sharply and audibly, then lets out a long, ragged breath. John knows that look – Sherlock is embarrassed at being unable to fight such sudden, intense emotion, and angry at himself for having to display it.

John clears his throat and Sherlock flinches, opens his eyes and stares at him with red-rimmed, bloodshot eyes.

"What's going on?" John asks gently after he has stridden to his partner. "Sherlock?"

Sherlock looks away, shifting his weight and shoving his hands into his trouser pockets. Highly evasive, but not fleeing. At least not yet.

"Have you got a patient at the ITU?" John suggests. Exiting the OR upset like this could mean that there's been a severe, sudden complication with one of Sherlock's OR cases since they tend to go to HDU or straight to the neurosurgical bed ward from the theatre floor. But, John has never seen a patient case get to Sherlock like this, making him shed tears in frustration. Sherlock is a highly emotional person when it comes to their relationship and other personal things, so John wouldn't put it past him to react to a patient this strongly if something unusually intense happened. Maybe he has been brutally chewed out by some relatives. That could do it.

Sherlock appears to be rapidly trying to collect himself by clearing his throat. "I need to go," he says and tries to sidestep John.

"Just wait a moment," John says, laying a hand on his arm.

"I was just visiting. It's nothing to you."

"Of course, it's bloody _something_ to me, if it's got you upset. Tell me."

"Your exposure patient. I--- I know him."

John's brows knit together. "You know this Victor Trevor guy? How?"

Sherlock pulls his arm out of John's reach. "We went to school together. We wanted to apply to Cambridge together, but he was expelled during Sixth form. Could have been me as well, but Mycroft intervened."

"Expelled? Why?"

Sherlock's composure crumbles, and his fingers are twisting into the fabric of his trousers. "He was my best friend. My _only_ friend. Before you," he says miserably.

"Alright," John says. "You haven't kept in touch, then? You didn't know he was sick?"

Sherlock completely ignores his question. "He got me into cocaine."

John scoffs. "Some friend he was."

"No, it's--- it wasn't his fault. I asked him for it, because I knew he'd done ecstasy at some parties, so it seemed like that he would know who to approach to procure other stuff as well. I didn't go to parties. Ever."

John is not surprised. Generally speaking, Sherlock still hates socialising and gets exhausted by it. They do see friends, and it has gotten easier during the past year after John had found motivation to try to understand better why it all was so difficult for his partner.

Sherlock doesn't talk about his past. Not his childhood, not his time at University, and especially not like this. John has respected that, which is why it feels strange that Sherlock is suddenly willing to divulge all this – that he's so upset by someone he probably hasn't seen for a long time being poorly. John doesn't remember ever hearing the name Victor Trevor before he'd read it on that lab result printout.

"I'd looked into the effects of stimulants on the brain chemistry of individuals on the Spectrum," Sherlock explains hastily. "I wanted to see if those suggested positive effects could manifest in me. I was hardly going to go to student health to ask for a Ritalin prescription, so cocaine seemed like the most easily obtainable option."

John refrains from expressing judgment. Everyone does stupid things when they're young, don't they? This was all a long time ago, and Sherlock hasn't used in years. Still, John had realised that he'd been a bit naive about the likelihood of a relapse when Sherlock had alerted him to the fact that he'd been frighteningly close to indulging when the halo vest and being on sick leave had strained his patience to the max. _Once an addict, always an addict._ Still, Sherlock looks so very far removed from the emaciated sight of the exposure patient at A&E.

"In a way, it's my fault," Sherlock insists, "As it turns out, he enjoyed cocaine more than I did. I thought of it as a necessity, as self-medication; it got me through exams and kept my head from exploding until I graduated. Victor used... because he wanted to. His father found out, and instantly cut him off his Trust fund, since Trevor senior thought it would wreck his political career. Told Victor he would cut all ties and that he'd have to learn his lesson; he wasn't allowed to come home until he'd sorted himself out. That's when Victor got expelled and started selling."

John interjects, "He's probably been using more than just coke, since he tested positive for morphine and tramadol metabolites." Cocaine is hellishly expensive for someone living on the streets, and the patient certainly hadn't looked like an MP's son with an accessible trust fund. Being a dealer would explain the coke, but not the homelessness. Maybe Victor Trevor hadn't been fit enough to run his business after he got ill.

"I haven't seen him since I left for Cambridge after the rehab Mycroft put me into, but I never stopped wondering what happened to him. I should have done something. I always thought I should have sought him out – helped him, somehow. I did help, at least in the beginning after his father cut him out. We lived in London for a while, and I paid most expenses until Mycroft put a stop to it, said I was just financing his habit."

John sends a telepathic thank-you to Sherlock's brother.

"I started running out of funds at that point, anyway, so I had to decide. I realised I had to leave him behind, unless I wanted to end up---" Sherlock doesn't say it, but John is certain his next words would have been _'like him_ '.

It could happen to anyone, ending up like Victor Trevor. John's own sister is an alcoholic, and the same had been true of their father. John knows of at least one army mate he'd served with on his first Afghanistan tour who has died of an overdose, and several of his school mates who hadn't found a way out of their family legacies of unemployment and addiction had fallen by the wayside.

Still, when he looks at his consulting neurosurgeon partner in a thousand-pound suit, that world seems very far away.

"I don't expect you to have any sympathy for him," Sherlock says bitterly. While his words are lenient, there is a hint of an accusation there. "Nobody does, not for patients like him."

"I don't have a problem with him. The needle stick was an accident; if anyone could have prevented it, it would have been me. It's not his fault he had a seizure."

"Still, there's always the chain of blame in people's heads leading right down to ' _he shouldn't have used'_. People never ask the right questions. They never ask _why_. Look me in the eye and tell me _you_ weren't at least a little bit tempted to roll your eyes like the A&E nurses always do when someone wheels in _yet another junkie_." Sherlock's eyes are blazing with anger, but John doesn't take offence; this is Sherlock trying to channel his own distress.

He is right, though. "You're not exactly Mister Sympathy when it comes to drunk drivers with head injuries, for instance," John gently points out.

"Drunk drivers are physically endangering _others_ , unlike someone who just uses."

"Drug addicts end up hurting others by extension," John argues. Due to having witnessed Harry's downward spiral, it had scared him to death when he'd come home from work that one day and Sherlock had been sitting in the kitchen, smoking and considering picking up his hard drug habit because the halo rig he'd been confined in had driven him to the brink of a breakdown. The helplessness, anger and frustration John has carried for Harry for years had reared his ugly head, and it's the last thing he wants to associate with Sherlock. Thankfully, Sherlock had reached out to him and they had managed to circumvent disaster together.

Harry is a different person when she drinks; John doesn't know the person Sherlock becomes when he shoots up. He doesn't _want_ to know that Sherlock, not ever, but he shouldn't pretend that person doesn't exist.

Sherlock pretends, too, when he hides things – when he acts as though those years he doesn't like talking about didn't happen. What else is hidden there besides this Victor Trevor guy?

"He's dying," Sherlock says plainly, and in his glassy eyes John reads guilt and sorrow for someone who had once meant a lot. "His bronchial lavage samples came back positive with Pneumocystis on top of the Mycobacterium – not TB but some _avium_ subspecies. They can't even assess how badly the encephalitis is affecting him unless they taper sedation down, which they can't do because he's had two more Grand Mal episodes during sedation breaks. Unless the retrovirals kick in and reboot his immune system, they say he'll probably have days at most." The cold facts seem to help Sherlock retain his composure.

John knows it's unlikely that the patient's CD4 immune cell count could climb back up to life-saving levels from such a low starting point, especially during acute illness this severe. "Now that they know who he is, have they got hold of any family?"

"His mother's dead, there are no siblings, and his father still won't have anything to do with him. They can't even get that bastard on the phone, just his secretary." Sherlock lets out a hollow, mocking snort. "It's logical that he'd keep his distance, especially now. That'd make the tabloids rejoice – finding out that an MP with a tediously clean reputation has an abandoned junkie son dying of AIDS."

His own, harsh words seem to shock Sherlock; his breathing picks up, as he fights an onslaught of angry tears.

John knows better than to throw in more questions. Instead, he wraps his arms around Sherlock after glancing towards the hallway which is thankfully empty. Not that it matters if someone sees; everyone knows they're engaged. Still, John doesn't think public displays of affection are proper form in a work environment – apart from a midnight sneak into an on-call room – and even that has been off the menu after their relationship had stabilised after the tumultuous start. Sherlock certainly wouldn't want their co-workers to see him when he's not in control and employing his usual cold mask of superior indifference to sentiment.

"I tried," Sherlock mumbles into his shoulder, crunching up the back of John's jacket in his fingers. "I thought if he had money, he'd at least stop selling," he quietly tells John's neck hair.

When he pulls back a moment later, John gives him a tissue he had shoved into his pocket a few days prior.

Sherlock dabs at his eyes and John watches as he squares his shoulders and summons his game face. "I need to go prepare for a stereotactic biopsy," he tells John, tone now almost completely devoid of emotion.

John watches him walk away, marvelling at how the universe works: if he hadn't been injured, Sherlock would never have learned what happened to his friend. It's strange that it had to be this Victor Trevor, of all people, who is the source of John's hopefully temporary discomfort.

 

-o-0-o-0-o-0-o-0-o-0-o-  
  


Four days later, John finds Sherlock in their sitting room, hunched over his laptop and worrying his lip as he studies something intently. John expects it to be a journal article when he deposits a mug of tea on the coffee table next close by, but when he glances at the screen he sees scanned photographs.

He sits down next to Sherlock on the sofa. The glance he receives is, at first, wary – as though Sherlock isn't sure he wants John seeing what he's looking at. Then, as though having reconsidered, he slowly turns the screen so that John can see better.

There's a picture of about ten students sitting in class, wearing immaculate grey trousers and blue blazers, their straw hats placed on the desks in front of them. They all have black ties. Sherlock zooms in, and John spots his very distinct and familiar face in the third row.

"Is this from Harrow?" John asks. He knows Sherlock attended it from year nine all the way through sixth form.

"Yes. Fifth Form year."

John tries to look for Victor Trevor, too, in the photo, but his appearance has clearly changed a lot more through the years than Sherlock's, and John can't be sure which one of the boys he is.

"Victor is not in this, if that's what you're thinking. I was Newlands House, Victor was Rendalls. We didn't have a lot of classes together."

"I assumed Harrovians all know each other, anyway."

"There are over seven hundred boys at the school, and I was not interested in spending time with other students. I would have preferred to be left alone, but the House Master assigned me to tutor some classmates in science so that I would _interact more_. That's how I met Victor. He wasn't doing well in physics or mathematics. He'd have done fine, had he been bothered to put in the work, but he preferred sports to academia. He had trouble choosing a Sixth form curriculum because he had no idea what he wanted to do after; hence his combination of subjects was not very really geared towards anything specific."

"I assume you picked the stuff that was important for medical school?" That's what John had done. The idea of becoming a doctor had come to him during year nine, after watching a documentary on the telly about surgery.

"I did focus on natural sciences but never really saw medicine as an option during school, especially since I was repeatedly and specifically counselled against considering it. Mycroft was particularly sceptical, but eventually he was willing to support any plan that didn't involve another gap year. ' _On your head be it_ , _but don't tell me I didn't warn you when they tell you your social skills are too inadequate for clinical work,_ " Sherlock skilfully imitates his older brother. He then clicks the next photograph forward; it's an image of a rowing competition between Cambridge and Oxford. "Victor was in the team. This was his last year before he was expelled."

"I didn't know you took a gap year. Where did you get these?" John asks. The photographs are grainy, likely scanned from paper versions.

Sherlock brings forth the next photo – a shot of him at his desk in what must be his dormitory room, hunched over a tome of a textbook. He doesn't appear to have noticed he's being photographed. "Mummy scanned and emailed them to me when I asked. Victor took this one, he got a camera for Christmas that year."

John is surprised. Sherlock doesn't usually sit around looking at old photographs of himself. It seems like he's trying to solve something – to make sense of the past?

John keeps in mind Sherlock saying that Victor was expelled and thus never graduated. "Is that you with him?" he asks when the next photograph comes on. The boy on the right with windswept, wild, blackish curls and familiarly gaunt form is obviously Sherlock. The boy on the left, pointing at something Sherlock is also looking at beyond the frame, has tousled, sandy brown hair and sizable biceps. They're on a beach somewhere.

Sherlock nods. "This was taken in Grimaud – that's in France – between Fifth and Sixth form; I was sent to visit Grandmére and allowed to invite Victor along. She died the next year and her house was sold after the funeral; I haven't been back there since."

It's very difficult for John to square the image of the patient he'd seen at A&E with the happy, obviously glowingly healthy and outstandingly fit youth in the photo. Out of the two boys, Sherlock is the one who looks like he could do with a bit more food, exercise and sun. Even as an adult, his complexion is naturally pale, and he doesn't voluntarily spend much time outdoors. Judging by these photos, that's what he's always been like – more the bookish type than a jock.

John tries to read in the photograph the precise nature of his connection with Victor – tutoring someone doesn't require friendship and certainly doesn't entail joint travels. He can't tell from Sherlock's expression whether further prying into such things would be welcome – at least not yet. The fact that Sherlock is talking to him about any of this feels very significant and the moment thus fragile.

"What happened after Harrow?" John asks.

Sherlock leans against the backrest of the sofa, gaze still locked on the old photograph. "I went to live with Victor in Brixton; we found a cheap flat."

"Didn't you get into Cambridge right away, or---"

"After they expelled him, we still spent a lot of time together. School had been, frankly speaking, hell, and I wasn't sure I wanted more of it even though I did see the benefits of higher education. I was pressured into applying to university by Mycroft, but I deferred my entry and told my parents I was doing a gap year."

"What did Mycroft think?"

"Mummy was a visiting professor at CalTech; they were living in the States. They left Mycroft in charge, to oversee my Sixth Form. You should have seen his face when I told him, flat out, that I was going to delay university for a year. He insisted that I was to spend that year improving my academic credentials; he got me an internship at a research group at UCL but I never attended it for a single day."

It still doesn't make sense. "Was that because you were using?"

"Hence the rehab. Do keep up, John. I did cocaine and various other stimulants to get through Sixth Form. The heroin came later... in London. Victor picked up the habit through selling it."

Anger flares up in John. Why the hell would Sherlock abandon further studies and follow a drug dealer to London? In his mind, there's only one thing that could motivate such a move."Were you and Victor... _together_?" he asks carefully.

Sherlock shakes his head. "He was tiresomely straight. And popular," Sherlock admits, sounding as though it's a dirty secret. "Had plenty of female admirers, many who shared his bed at some point. He thought he wanted to study law. I knew that if we went to Cambridge, he'd probably drift away into that crowd." Sherlock inhales, seems to consider something, then shifts his eyes even further away from John. "I may have been... smitten. He knew, deduced it somehow, said he thought it was flattering. I valued our friendship, so I decided to get over it."

To John such an unrequited thing sounds quite sad, and even more heart-breaking is the way Sherlock had phrased that last thing: instead of saying he _got over it_ , he had said he had merely made a decision to do so.

"Before you get jealous: although I might have wanted more, I was very satisfied with even the limited extent to which he wanted to share my life," Sherlock says.

It all sounds a little defensive to John. Sherlock had not had much of a choice: cut ties or accept that friendship was all it was ever going to be with this guy.

_As though you didn't deserve more. As though you don't deserve someone who loves you back._

"Don't look at me like that," Sherlock chastises him; "You watch too much TV; he wasn't some mythical first love I have been pining for ever since. I never let myself believe I might have a chance for a romantic relationship with him or anyone else. Whatever daydreams I may have harboured, they could always be easily rationalised as juvenile fantasies . We were friends, and having one had tremendous novelty value. I followed him to London, because if he could choose what he wanted to do with his life, I wanted that same right. We had each other, which was good because we were both unaccustomed to such a level of freedom. Together, we managed, but only barely."

"It's very hard for me to accept that he was a good thing for you, if he got you into shooting up," John comments. He tries not to be judgmental, but it's difficult, especially since he can't deny a slight bitterness over his own predicament with the needle stick injury lessening his desire to appreciate this Victor Trevor in any way.

Still, this is the first friend Sherlock has ever told him about, the first and _only_ friend he says he's ever had, and Sherlock's reaction to the state Victor is in speaks volumes of his importance.

"What made you go your separate ways, then?" John asks.

"Living with Victor, I didn't have any plans for the future. I had a spot at the chemistry program at Cambridge, but it was just something I was good at, not what I really wanted to do for the rest of my life. At first, London was great – during Harrow I didn't get out into town all that much, so getting to know the city was wonderful. But, once Victor began to use more, he got less interested in anything else. He got into debt. I did whatever I could come up with to spend my time when he wasn't around – sat in libraries and read, mostly; what I was mostly using made all-night reading binges easy. He partied, sold, I don't even know all of it. We got kicked out of the flat after he'd used all the money reserved for the rent. I saw less and less of him as the months passed and he was using more than he was selling."

"Were you homeless after that?"

"No. When we lost the flat I knew I had to decide: to go the way he was going, or to want something better for myself. After deciding I didn't want to throw away my life like Victor was apparently dread set on doing, so I went to Mycroft and he sorted out a spot at a rehab. He wouldn't let me contact Victor to tell him where I was going. I should have said goodbye. I should have done something. I should have looked for him, at least after I got back from Scotland."

"Scotland?"

"The rehab Mycroft sent me to for six months."

"Victor never got clean, then?"

"Not as far as I know. His phone number didn't work after I got back from Inverness. The only places available for someone without a penny to his name are the sorts of places nobody would want to go to. He wasn't motivated to get clean. He liked the lifestyle – at first, until it got him, and then he was so deep in it that getting out would have required herculeaneffort. Every day he swore his luck was going to turn. Most people would have eventually stopped believing, that but I guess his optimism exceeded his reach."

Sherlock rubs the crook of his left arm as though something is bothering him there. He has rolled up the sleeves of his white dress shirt, which he never does at work since he prefers people to not see the scarred veins. For the same reason, he always wears a long-sleeved shirt underneath his scrubs.

The next image appears on the screen: a photo of Sherlock from Sixth form graduation at Harrow. John doesn't search for Victor because he now knows he won't be in the photo.

"I let him disappear, just like that, and I shouldn't have," Sherlock says resignedly, looking at his younger self on the computer screen.

"He wasn't your responsibility. You had your own issues."

"What does it matter who has _responsibility_? You were hardly responsible for me, but you still cared enough even to break the law. We weren't even friends, I was just someone who came to you for help."

"I like to think you were more than that, pretty quickly."

"That applies to Victor too."

"You can't save everyone."

"But maybe I could have saved this one person."

"By doing what? Searching every halfway-house, bridge, park and bolthole in London for one man among thousands of homeless? Couldn't he have sought _you_ out, contacted Mycroft, _something_? He could have asked for help; not all the places that could have taken him in are worse than being out on the streets," John suggests.

"You're blaming him, now?"

"There's no point in blaming anybody," John placates.

"Except maybe his father for kicking him out and taking away his trust fund." The anger in Sherlock's tone makes John wonder how much interaction he'd had with Trevor senior.

John thinks about the missing rent money. "What do you think would have happened to that trust fund?"

Sherlock worries his lip for a moment, looking grimly at a wall with an unfocused gaze as though trying to force out memories he doesn't really want to think about. "I came back, let Mycroft sort things out so that I could re-apply to Cambridge – this time to medical school – and never looked back. Victor could have had all of that, too. I took the chance I got," Sherlock argues even though no one has challenged that notion. He sounds as though he's asking for permission.

"You don't have to apologise for sorting your life out. He wouldn't blame you for that. If he really was your friend, he'd be pleased for you."

"Well, he'll hardly be pleased for _anything_ , now," Sherlock points out bitterly.

"You didn't make Victor start using. You didn't make him sell. You didn't make him share needles, or however he got infected."

"If it weren't for my request, maybe he would never have used anything beyond a few Es at parties."

"If he hadn't given you anything, maybe _you_ wouldn't have started using. Sherlock, you can't take responsibility for all his choices. It doesn't work that way."

Sherlock clicks to open one more photo. It's a scanned clipping from a school bulletin; clad in grass-stained rowing gear, Victor has been hoisted onto the shoulders of his teammates, holding a large trophy.

"His teammates couldn't understand why he would have befriended me. Initially I assumed it was out of pity, or gratitude over assistance with his studies but eventually I started to believe he genuinely wished to spend time with me."

This is the Sherlock John knows as well – endlessly insecure about anyone ever wanting anything to do with him. A thousand times shunned, insulted and belittled. Deeply sceptical of things ever improving. John is so bloody proud of him for taking a risk and reaching out to someone that one time four years ago, despite all his well-cemented beliefs that no one would ever want the best for him. The world is full of forgettable, agreeable people; John had always found them boring. Instead of being put off by the new neurosurgical registrar who was supposed to be intolerable, John had been curious to crack the case of why he behaved the way he did. Victor Trevor may well be a part of that puzzle – and, if not, he still sounds like someone who had once been the most important person to Sherlock. That is reason enough to want to know as much about him as possible. Or, at least as much as Sherlock is willing to tell him.

John puts his mug on the coffee table and lays his palm on Sherlock's arm to get his undivided attention. "You don't have any kind of magical bad karma for wrecking people's lives or making them run for the hills. You _saved_ mine. Honestly. During the past two years, you've saved me in more ways I can count. You shouldn't let yourself take the blame for Victor. You were both practically still teenagers, for God's sakes. I'd blame his dad for not helping him like Mycroft helped you. Abandon a kid just because they made one mistake? Christ."

That's what John's father would certainly done, if he'd found out he was doing drugs. After a good beating, of course.

"At least now I know what happened to him," Sherlock says, and closes the lid of the laptop. He sips his tea, glancing out towards the balcony. "Someone should have done something."

A pragmatic part of John wonders if it might have been for the best if Sherlock and Victor's paths had never crossed again; it doesn't exactly seem like much good will come out of Sherlock watching his decline at the ITU and blaming himself. Sherlock can't change the past, and Victor's future looks bleak. What is there to do except to hope and to watch?

Then again, isn't the truth always a good thing? If this was John's good friend, wouldn't he want to know what happened to them? "Have you been visiting him at the ITU?"

"Yes. They won't lighten the sedation unless they see an improvement with his lungs. They've even been keeping him periodically on his stomach since his oxygenation ratio keeps getting worse."

Turning an ITU patient on a respirator is no easy feat; John knows a change of position is quite a desperate attempt to improve oxygenation. ' _I'm sorry'_ is what John wants to say, but in his head, it makes it sounds as though Sherlock is some sort of an advocate for Victor; someone whose fate is so tied to his that any misfortunate or expression thereof hurts them both.

He doesn't like seeing Sherlock upset like this; he's tempted to tell him to let it go, to walk away, to put the whole thing out of his mind since there's not much he can do for Victor. John tries even to be a bit jealous, but all he sees in Sherlock right now is someone who cares so much that it's breaking his heart, and it would be belittling to try to slot such caring under a neat label that probably fails to describe the complexity of his relationship with Victor. John doesn't have the right to try to define it – he wasn't there – and now, there will probably be no chance of real closure for any of the parties involved.  
  
  
  
  



	5. Chapter 5

 

>  
> 
> **"Because grief is a tidal force, it sometimes comes to the surface to wash over us in a powerful surge."**  
>  – Jonas Gardell, " _Döden_ " (" _Death_ ", translated by J. Baillier)
> 
>  

  
"This is Mister Holmes' office, to schedule a call."

John's left eyebrow hitches up, even though the woman at the other end of the phone line obviously can't see such a thing. "Um, yes?"

"Would this afternoon at fifteen past three be convenient?"

"Is Mister Holmes there? I could talk to him now, instead of scheduling something."

"Mister Holmes is currently unavailable."

John sighs. "Sure, three fifteen's fine." He wonders if this is about Christmas, or Sherlock's birthday which is a month after that. Mycroft seems to always act as the spokesperson and organiser of the Holmes clan, nagging at Sherlock until he relents to a courtesy visit to Surrey where his parents live. John has accompanied him several times; he finds Sherlock's folks generally pleasant and they treat him warmly, but his opinion of them is coloured by what he has learned about the Holmes boys' childhood. It seems that their parents hadn't had a very hands-on approach to handling their children, opting for nannies and boarding schools and therapists instead. And, together with Mycroft, they had actively discouraged Sherlock from trying to engage with others and considering what career options really interested him. They'd tried to shove him towards a solitary life and a career in theoretical science because they didn't believe him capable of anything else.

At the appointed time in the afternoon, John's desk phone does ring, and the caller sounds different than the woman who had contacted John earlier in the day. _How many bloody secretaries does Mycroft need?_

"Watson."

"This is Anthea Harris from Mister Holmes' office. He's ready for you now, sir."

"Right, good."

John is forced to listen to a raspy rendition of Vivaldi until the call connects again.

"Good afternoon, John."

"Mycroft."

"How are things?"

"Fine," John phrases carefully. "What's up?"

"That is what I should be asking you. Why is my brother requesting photographs of Victor Trevor from Mum--- our mother?"

John sighs, aware that it will be heard by the older Holmes. "Shouldn't you be asking Sherlock?"

"I am asking you, because I do not wish to risk inadvertently encouraging him in this matter because he wants to spite me."

 _If you didn't exhibit your brotherly love mostly through scheduled conference calls, maybe he wouldn't._ "What does it matter if he wants to take a trip down memory lane?"

"That young man was not a good influence for him. I won't sit idly by if he starts entertaining the notion of going down that road again."

"He's not entertaining anything. He's clean, has been for years. Judging by everything I've seen, you don't have to worry." John refrains from explaining what this assessment is based on. He is damned proud of Sherlock for coming to him when the halo vest and their relationship issues had been driving him into such a level of frustration and antsiness that he'd been tempted to use again. The addiction will always be there, but despite his impulsiveness and how difficult that period had been for Sherlock, he had asked John for help. It does frighten him how close Sherlock had been to succumbing.

"You were not there to witness his downward spiral," Mycroft dismisses.

"And you're not really here to witness how well he's doing."

John has never really liked Sherlock's older brother that much. He finds the man tolerable but knows how sceptical the older brother has always been of Sherlock succeeding in so many things that John can't help but incubate some resentment. If Sherlock had listened to him more, he would never have applied to medical school or embarked in a relationship.

"You didn't answer my question. Why Victor Trevor, and why now?" Mycroft insists.

"I can't tell you much – it all falls under professional confidentiality – but Victor is not well."

"So, they truly are communicating"? Mycroft asks, sounding like a war general preparing for attack.

"No, they're not. As I said, I can't tell you any more details, so you just have to take my word for it: you don't need to worry."

"I don't find so vague a statement reassuring at all."

"He's not a teenager under your supervision anymore. He's a bloody consultant surgeon, Mycroft, and he makes the decisions about who he sees or talks to."

"And you are fine with this?"

Mycroft doesn't even know what _this_ is. "Yes, I trust him. There's obviously things he needs to process about what happened back then."

"Water under the bridge, John. He should be glad that part of his life didn't wreck all his chances of ever achieving an independent, self-sufficient, meaningful adulthood."

"You don't have to rub it in, for fuck's sake. I know what happened. He told me."

Mycroft scoffs and John is tempted to ring off right then and there. "He's lucky to have escaped without permanent damage to his health," Mycroft dismisses.

"He knows that perfectly well," John snaps back. He has wondered if part of Sherlock's shock comes from realising that if he'd continued down that road – let Victor drag him into the depths – this could have been him. John realises that while Sherlock had told him about his drug use, it hadn't really occurred to him to worry about the associated risks when they began sleeping together. The NHS's mandatory HIV testing had ensured that Sherlock does not carry that particular virus but hepatitis C – relatively common among IV drug users – could have been a possibility. John hadn't taken this seriously, because he didn't want to think about such things. He had refused to negotiate his image of Sherlock with those facts of his past, and it hadn't been until Sherlock had broken his neck that John had been forced to accept the entire truth of his hard drug history. His shock of learning about the speed-balling still reverberates.

"With all due respect, I don't think you appreciate the time and effort it took to get Sherlock off the proverbial sauce," Mycroft points out like a broken record.

"You don't _get someone off the sauce_. I know this much: for long-term sobriety, the person needs to have innate motivation. It's not enough just to be carted off to some castle in Scotland for six months. If the addict isn't interested in staying clean, they'll go back to using."

There's a silence at the other end.

"He left all that behind, unlike Victor Trevor," John continues. "Maybe, instead of just talking about bad influences, we should consider that maybe Sherlock tried to be a _good_ influence on Victor."

"I do not give a whit about Victor Trevor," Mycroft snaps.

"That is precisely the point. Maybe Sherlock was – is – the only one who does," John says and puts the receiver down.

  
  
-o-0-o-0-o-0-o-0-o-0-o-

 

Two nights later, John wakes up to Sherlock shifting around in bed. There's something about his breathing that broadcasts frustration, so John turns around to face him in the dark. "Can't sleep?"

"Obviously not."

"Out with it, then," John says, a sleepy smile already sprouting through. When Sherlock's brain gets stuck in a loop with a problem he's trying to solve, insomnia is the first step and a dramatic daytime sulk is the next. If John can stop the vicious circle at this point by offering a listening ear, it'll give them both an opportunity to not be tired tomorrow after too little sleep. It just might prevent a tense day at work. John has learned to appreciate opportunities to talk to Sherlock like this, in the safety of their bed.

"I don't know why Victor started using. I know why I did, but I can't work out his motives," Sherlock explains.

John can't see his frown but he's certain it's there, crunching up tiny lines around his nose. "Well, I bet most just have a try and then get hooked without much a conscious decision-making process," John offers. He has no personal experience apart from a few puffs from friends' joints during Uni parties. Maybe Victor had just been young and a bit reckless and wanting to experiment.

"He had things. Things I didn't. He had his rowing team mates, and his friends, and his family, and he could have done whatever he wanted. Yet, he... He just let it all slide."

That John _can_ relate to. "Not all people have a plan. If they don't know what they want, they might not be very motivated to do well at school or Uni." He hadn't been a top student but wanting to go to medical school had helped during his teen years when everything else had trumped school in terms of having fun. John had thought that becoming a doctor would be a path in itself, but midway through medical college it had dawned on him that there were probably a thousand different career paths for a medical graduate, and he didn't really know what he wanted to do with his degree. The career path he eventually took mostly consists of drifting around, seizing short-term opportunities and chasing an adrenaline high. Until King's College and Sherlock, of course.

"I didn't have plans. I had plans enforced on me, but they weren't my plans," Sherlock says. "As I explained, I started using because there was some evidence that certain stimulants might be beneficial to improve focus and lessen social problems. Then, when I started using more, the idea became tempting to just let go – to let myself become such a hopeless case that they'd give up on me. Finally."

"Who? Your parents?"

"To say that they were supportive would be an understatement, but they weren't supportive of what I wanted, just what they thought I should do. They were so determined to give me the same opportunities as everyone else that they made damned sure I seized those opportunities, whether I wanted to or not. And, they weren't really the _same_ opportunities, just the ones they thought I was suited for. There was an endless parade of therapists tasked with helping me blend in, to conceal certain issues. It was relentless. They thought that if I _could_ get into academia, I should, regardless of the cost. Whatever was difficult for me, they'd force me to go through it. I was sent to boarding school; team sports were the worst thing. I just wanted it to stop. It's ironic, really, that I really discovered medicine as a consequence of trying to distance myself from all that."

"So, you followed Victor to get away."

"I thought that all those things he had – freedom and friends, among other things – might stick on me, somehow. A remora on the side of a shark. But it doesn't work that way. For me, he was an opportunity. For him, I became a burden."

"It also can't have been easy that you wanted more out of your relationship than he did."

"I can't be absolutely sure whether there was something there he chose not to explore, a side of him he chose not to acknowledge, or if it was just wishful thinking on my part. It seemed logical – I never expected to really find someone; even friendship, the kind that I had with him, was more than I could have hoped for."

"You deserved more. Everyone deserves more," John tells him sternly. "I hope as hell he wasn't partially responsible for you thinking that you aren't cut out for relationships, because that's absolute crap."

"No, he even--- tried to encourage me to, well, date? I had no interest in the people inhabiting the circles we moved in. First it was stuffy upper-class twits, then a more unsavoury crowd. I wasn't interested in other people, as long as he was around."

"You were in love with him."

"It feels so pointless to say such a thing, now. You must hate this conversation."

"I'm not jealous. You know _I_ dated, before you. It's fine. We all have a past."

"I don't like using that word about him. I'm _in love_ with _you_ , and what I had with him pales in comparison. I don't like calling it the same thing."

John gives him a kiss on the cheek; aiming is hard, since it's so dark in the room; it ends up half on Sherlock's ear. "You don't have to understand his motives; trying to do that sounds like you're still trying to work out if this is all your fault."

"I know he made his choices, but it's often impossible to predict a chain of events that starts from a single, small decision."

"If you hadn't followed him to London, you wouldn't have discovered medicine. Maybe you would still have had your rebellion years later and done something even more disastrous than what happened with him. Like you said, the irony is that you found what you wanted to do because you wanted to get away from it all."

John had to get shot in the shoulder to realise what he wanted, and that he had it already. Maybe Sherlock's gap year was about realising the not all aspects of the path his parents were trying to enforce on him were that bad. Still, it was clearly important for Sherlock that it was his decision to take that path and not theirs.

"It could have been me, what's happening to Victor. I would only have had to be a little more careless, a little more desperate," Sherlock says bitterly.

 _Maybe this is what's really bothering him_ , John muses. "Those words don't really describe you."

"You didn't know me back then."

"I know you _now_ , and there are other reasons besides just luck and timing that can lead to a different path to what he took. You may have been careless and desperate when you were younger, but you were also determined and hopeful that there was more to life than that. You don't have what you have now because you took something away from Victor or betrayed or abandoned him. You didn't give up on yourself – you never do. You shouldn't feel guilty: even now, years after you'd parted ways, your first impulse is still to feel guilty over not helping him. You try to help people, even when you don't know how. You never give up on someone you love, and that is  _definitely_ the Sherlock I know."

  
  
-o-0-o-0-o-0-o-0-o-0-o-0-o-

 

A week later, Sherlock appears in John's office, looking sombre.

"I was just about to call you to see if you were available for lunch," John says, stands up and grabs his jacket from the back of his chair. "Did you want to see me about something?"

"My request may offend you, considering you're still on the antiretrovirals."

John has five days left on the medication. "What do you mean?"

"They're withdrawing care from Victor today. I thought I'd---- attend. The CMV encephalitis has led to a massive cerebral infarction and the double-microbe pneumonia is not clearing. They've done the tests; there are no brain stem reflexes and he won't trigger the pressure support mode of the respirator."

This means that, even if Victor could somehow survive the pneumonia and not contract some other opportunistic infection before his CD4 cells climbed up, it would all be for nought. Absence of spontaneous breathing and brain stem reflexes translate to only one thing: brain death.

Lying in the uncomfortable bed in the on-call room after his needle stick, John had been angry at both himself and every damned person who had ever shot up and got themselves infected. But, once the initial shock and rage had subsided, he didn't blame anyone. These things happen in his line of work, and nobody _chooses_ addiction when it's fully developed. Nobody chooses to die alone, isolated at an ITU, their immune system decimated by a virus that even in this day and age still makes them undesirables in the eyes of many.

John stands up, squares his shoulders and meets Sherlock's gaze. "Of course I'll come with you."

 

-o-0-o-0-o-0-o-0-o-0-o-0-o-

 

At the ITU, Sherlock dithers before entering the single patient room. There are no signs on the door announcing why the patient is in isolation – HIV is classed as a blood-borne pathogen, and every patient ought to be treated as a potential source of such contagion. Only more easily transmittable or untreatable diseases warrant heavier quarantine measures – Ebola, CARDS, MERS, chicken pox. Giving Victor Trevor a single room is not for the protection of others but for his own safety since his immune system has been decimated into nothingness. Common bacteria which healthy individuals are perfectly protected against could wipe him out.

Such things _are_ wiping him out. _Have_ wiped him out.

Most people dying from HIV infection don't even get a hospital bed, since they don't live in prosperous Western world countries. There are plenty of HIV patients in Afghanistan, but John hadn't met many of them since they did not wind up in military hospitals. Hidden away at home or among the homeless populations of bigger cities, they were mostly intravenous drug users. In contrast, London has a lion's share of Britain's HIV positive patients, and most of them live with a chronic disease that's well-managed by modern retroviral therapy. It's very rare, now, to encounter a patient such as Victor with untreated, full-blown AIDS. As a matter of fact, for John, he has been a first on British soil. Or, the first that he _knows_ of. He has helped stabilise many patients with severe, strange infections at various A&Es who knows which ones may have had HIV as the predisposing factor to their acute illness?

He trails into the room behind Sherlock. The nurse stationed there gives a nod from behind a laptop. It's quiet except for the faint whirr of automatic infuser pumps and the respirator.

Sherlock takes up a position by the bed, curls his fingers around the side rail which has been lowered half down. Victor's eyes are closed, sunken into deep, bruised sockets. The brown plaster tape holding his intubation tube in place has chafed his thin, raw skin into a red welt. He's ghostly pale, and very little fat covers his atrophied muscles.

John tries to imagine him as the young man in the photos: healthy, happy. Or, perhaps not _that_ happy since something had made him turn to the drugs. Perhaps there was some darkness he hid away, just as John had hid away what was troubling him before and after Afghanistan. What John has learned during his time as a doctor and from talking to Sherlock is that his ideas of why people do drugs have been terribly naive.

The door opens, and the nurse rises to her feet when Doctor Hyong and one of the ITU's staff doctors, a senior consultant in internal medicine, enter.

"John," Doctor Hyong nods. "Doctor Holmes."

John has made note of the fact that Hyong doesn't use the surgeon-specific, archaic denomination 'mister'. He seems to be very much an advocate for equality in all matters.

The internist greets them with an "afternoon", courteously refraining from using the word _good_.

Sherlock says nothing, doesn't even shift his gaze away from Victor.

"No next of kin due to arrive, so I think we'll proceed," the internist says.

John knows there will be no discussion of organ donation. There may not even be a need for an autopsy – the cause of death should be obvious enough. There will be a funeral, likely attended by very few. John wonders if Sherlock will want to go, or if this is the last goodbye.

"Last CD4 count was 12, and there is no evidence of meaningful cerebral activity," Doctor Hyong says quietly, perhaps as final confirmation that what they are about to do is acceptable.

John retreats to standing by the door as the internist goes to the respirator, brings up its main menu and stops ventilation. To prevent air pressure from the machine passively continuing to oxygenate the patient, he disconnects the intubation tube from the thicker set of tubes connecting it to the respirator. Doctor Hyong goes to turn off two infuser pumps – one dosing noradrenaline to keep the blood pressure up, and another which has been infusing an antiviral agent. The two physicians then retreat to the foot of the bed almost ceremonially.

For the internist, this must be a relatively frequent part of his duties at the ITU, and Doctor Hyong's age guarantees that he has likely participated in such decision-making countless times. John, too, has been the one to turn off the ventilator many times at A&E and in the OR and during his training periods at various intensive care units when a case has turned from desperate to hopeless.

It's still sobering for all those present. Even though they are not determining this patient's fate – the hopeless prognosis of the illness is – they are determining the moment when the inevitable happens. As John watches the still, emaciated human on what has become a death bed, he feels guilty and petty for his own worries about the needle stick. His risk is contained, acknowledged, and he's being protected by the same system that abandoned Victor Trevor. The same system that cannot help him anymore.

The breathing rate count on the monitor goes to zero; Victor has had no strength to try to breathe on his own, not even with the support of the machine, and especially not through the cocktail of anaesthetic drugs he has been on to keep him comfortable. Those had all been discontinued before the brain death tests to ensure that the results were accurate. Blood pressure, measured continuously through an arterial line, begins dropping when the noradrenaline's effect wanes away.

Hyong presses the alarm break button on the monitor, and the high-pitched beeping stops.

Silence stretches on, and the long hand of the wall clock jerking forward minute by minute sounds loud and inappropriate.

Sherlock reaches out for Victor's hand where it rests on the sheets, clasps it in his own. He says something quietly which John cannot make out. It doesn't matter, because it's not meant for him to hear.

The oxygen saturation reading on the monitor begins to drop slowly but steadily. Below sixty percent the reading is not reliable. Seventy-one. Seventy. Sixty-nine.

"I'm sorry," Sherlock whispers, and swipes his palm across his eyes.

John wonders if he should step closer, to comfort his partner somehow, but this moment is not for him. He's an intruder – all of them are, except for Sherlock. John doesn't know Victor – has never spoken to him, has never seen him the way he was before the virus stripped him of his health and his dignity.

Sherlock removes the pulse oximeter from Victor's forefinger and drops it on the bed just as the ECG begins showing an erratic heartbeat before degenerating into bradycardia.

"Victor," Sherlock whispers, and that name contains a statement that is much more than its two syllables. It's a promise of being remembered, an acknowledgement of the person this waning life had been before, and assurance that Victor won't die alone and anonymous – won't be just a John Doe among John Does. Not just another homeless person lost between the cracks.

Asystole begins: the green line on the ECG monitor wavers a little, but it's still just a line. The air in the room feels heavy and still.

Hyong walks to the bed with a stethoscope in hand – the declaration of human demise demands its rituals. He places two fingers on Victor's neck. "No pulse." He listens to the lungs: "No breath sounds." He then reaches towards Victor's eyes to test for a corneal reflex.

"Don't---" Sherlock pleads, but doesn't reach out to stop Hyong.

Victor's hand is still protectively resting on his palm on the bed. He looks away as Hyong pries open a lid and gently touches the surface of Victor's eye with his gloved finger.

"No corneal reflexes. Time of death: 13:58," Hyong calls out quietly, and the nurse jots this down.

"Do you want a moment with him?" The internist asks Sherlock, who nods.

The three other doctors file out of the room. They could go to the break room to have tea, could resume their duties, but only one does – the internist excuses himself and brings his phone to his ear as he begins a walk down the hall.

John and Pak Hyong stand in the hallway outside the room. Lingering. Being. Waiting, although the wait is really now over, at least for Victor Trevor. Death in a hospital is a part of life, but it's also a pause. A missed step. A skipped beat. Something that jolts the staff into remembering what it is they are effectively battling against, and always losing to eventually. It claims everyone in the end –  it's just that some lives are snuffed out before their time, while others linger on even though theirs doesn't seem to be worth living anymore.

"They were friends," John tells Hyong, who nods. He shouldn't feel a need to explain, to offer an excuse why someone would want to keep company to a dying man. Maybe Hyong had already deduced as much, and perhaps, after everything the older doctor has seen and experienced, he has simply taken Sherlock's presence at face value.

"This is what it used to be like, in the early days," Hyong tells John. "Isolation rooms. Families wouldn't visit. Even if they did, they would say to the patient's partner that they are not allowed to be present. It was most often just friends who visited, who understood, who weren't afraid, because many of them were infected, too."

John hadn't been a doctor yet when the HIV epidemic had reached Britain, but he remembers hearing adults talking about it. Nobody wanted to accept it affected them in any way, at least not until the first straight people got infected. The majority of people clung to the idea that HIV was something that _other people_ – people they saw as morally deplorable – got.

Hyong shoves his hands into his trouser pockets. The brown suit he wears is worn and looks a bit big for him. Had he had it back in the day, worn it when telling patients the devastating news that they had caught the disease nobody could cure and very few in power positions seemed to care about?

" _The gay plague_ , the tabloids called it," Hyong recalls bitterly, "and they continued to use that term long after they'd proven it could also be transmitted through straight sex and sharing needles and through maternity. Many colleagues wouldn't treat the patients, some even said that the disease was God's punishment. Supervisors looked elsewhere while the discrimination happened. The medical community named it GRID, at first – Gay-Related Immune Deficiency."

John suddenly remembers what Sherlock had said – that the medical establishment should be ashamed for the way it has treated certain groups of people. Listening to Hyong, he now feels a bit embarrassed because he'd belittled Sherlock's ire over the nurse's prejudice. Homophobia from a middle-aged woman might seem like a small thing, but the ripples of it speak of a larger reservoir of prejudice still simmering in society and even public healthcare that is supposed to look after everyone.

"I lost a lot of friends during those years," Hyong says gravely.

John thinks he can hear something more behind those words, a secret that is being passed on. Wedding and engagement rings are not permitted to be worn at wards, and Hyong never talks about his private life so John has no way of knowing if he is married or single, whether he's straight or gay or something else.

Hyong's mouth stretches into an angry line. John has never seen the usually reserved man this openly emotional; Victor's fate truly must have caused some strong memories to stir. "Many didn't even want to be tested because there was nothing that could be done except to hide them in isolation rooms. The higher-ups nodded to the hysteria, wrote up instructions such as ' _don't_ _dry the patient's tears without wearing gloves'_. The gist of those instructions was that they weren't human, anymore – they were a biological bomb needing to be contained and removed once dead," Hyong says.

John is now doubly embarrassed about his complaining about the side effects of the antiretrovirals. He's so, so lucky, having a near-guarantee that he won't get infected, that he won't ever get sick, that no one will discriminate against him like that. It's hard to even imagine what a person queuing up for an HIV test during those early, desperate years would have felt. It had been an act of courage to even ask for a test.

"I am sorry. This is just bringing back many memories," Doctor Hyong says courteously and straightens his tie.

"It's alright," John tells him. Who wouldn't be affected, watching someone Sherlock's age wasting away with something that could have been not cured but at least managed?

"There is no need for post mortem, I think. Pathology hates these sorts of cases," Hyong says resentfully, "even though any one of their patients could have had the same. Anyone. You can't know. You can't see the infection on a treated patient."

John nods. He knows, and Hyong is probably aware that he knows; this is about the infectious diseases specialist needing to vent. If Victor had been diagnosed in time, he could have had another chance at life. But, maybe his and Sherlock's paths would never have crossed again. Life is decisions and coincidences and setbacks and unfairness the likes of which John himself has experienced with Afghanistan and its aftermath. If a bullet had hit him a few centimetres off where his scar is, he could have bled to death. If the piece of bone that had broken off Sherlock's second vertebra had lanced through his spinal column, he might be now bedridden and dependent on a ventilator instead of continuing his career as a neurosurgeon. If Victor's father had been different – if Victor and Sherlock had never met----

Hyong leaves without a further word.

For a few minutes, John watches the bare branch of a tree tapping on the window in the grey light of the cloudy day. A nurse is stocking a trolley with what will be needed to prepare the body. John notices two body bags with biohazard symbols; maybe it's because Victor's viral load had been so high.

John slips back into the isolation room. The light streaming in through the window blinds is cold, and the shadows of tree branches dance on the walls. Someone has turned off the halogen lights in the ceiling – John knows Sherlock hates them.

Victor's nurse has left the room, presumably to help with arranging transport for the body. There won't be a need to keep it here – to keep _him_ here – since he is unlikely to have any other visitors. John glances at Victor, motionless in a way a doctor with at least a few years' experience would instinctively recognise as dead. The impulse to call for help, to leap into action at the lack of vital signs is only a dim thrum at the back of John's consciousness, easily suppressed by reminding himself this is how things now are. That it's alright.

Sherlock is standing by the window, his back to the door and his arms crossed. His jacket is folded onto the chair next to the bed.

John goes to him, wraps his arms around his waist from behind and perches his chin on Sherlock's bony shoulder. Neither says a word. The fingers of Sherlock's right hand creep up briefly to touch John's knuckles, then descend again. After a moment, he gently extricates himself from the embrace.

"Have you got a pen and paper?" Sherlock's eyes are red-rimmed and voice hoarse.

"Have I got----" John is momentarily confused, then the words finally register, and he spins around to glance at the nurse's small desk in the corner. He grabs a pad and a biro and passes them to Sherlock, who sits down and starts jotting something on the pad. He didn't even take the jacket off the chair before taking a seat; usually, he's meticulous about his clothes getting crumpled.

"What are you writing, love?" John asks, placing a palm on his partner's shoulder and giving it a little squeeze before tucking an errant curl behind Sherlock's ear.

"A letter to his father."

 

 


	6. Chapter 6

 

**––– Three weeks later –––**

**  
** There's a headline in The Sun that makes the issue fly off newsstands: _'MP Trevor tries to hide attending the funeral of the HIV-positive homeless son he rejected!"_ A smaller headline beneath declares: _'Burial costs covered by King's College neurosurgeon_ '.

Said King's College neurosurgeon, who also happens to be the anonymous informant who leaked the story to the press, isn't in London to see these headlines – he is currently enjoying the views over the Aegean Sea from the Hotel Grand Villa Canava 1894 on the island of Santorini.

His partner glances up from his paperback and sheds his Ray-Bans despite the glaring sunlight to properly appreciate the sight opening from this terrace high up on the side of the steep Santorini coastline. The smaller island of Thirasia appears to be almost floating in the turquoise sea and the pool from where Sherlock has just waded out of blends seamlessly into the sea far below, since its edges are made of plexiglass.

The best part of the view, however, is the mischievous smile on Sherlock's face as he takes in the sight of John in nothing but black swimming trunks.

"Not a word about the love handles," John warns him with a mock serious expression. "Not everyone has your bloody male model genes."

"I’m not complaining; they give me something to hang onto," Sherlock says with mock seriousness while running a hand through his wet curls. Due to his good mood, John doesn't even complain about the droplets landing on the cover of his mediocre-at-best crime novel. He puts the shades back on so that he won't have to squint. "I'm glad you talked me into this."

They had been talking about visiting Greece, but it had been Sherlock's idea to make that happen sooner rather than later. Some considerable rearranging of schedules had been required, but then again, it'll never get easy to take time off from their careers.

Sherlock makes a graceful landing on the sunbed beside John. They have spent time sitting around the hotel pool nearly every day; Santorini's beaches are on the other side of the island, requiring transport, and the pool offers the benefits of both a magnificent view and a quick access back into their room for a shag. "I think we both needed a bit of a breather and a chance to celebrate your test results having come back all negative so there's no need to limit interactions," Sherlock muses.

"Is that what we're calling them now, _'interactions_ '?" John teases him. Usually, Sherlock is blatant up to the point of embarrassing John in public with his statements about their sex life.

"It was a shame how all this happened just as we were getting back into it after, well---." They can talk about Afghanistan and its aftermath, now – quite freely in fact – but Sherlock seems to still be avoiding doing so when they're both in good spirits. "I hardly need to remind you that symptoms of stress include insomnia, low energy, irritability, frequent colds and infections, loss of sexual ability and libido----" Sherlock lists.

"Keep your bloody voice down!" John says, but the protest is half-hearted. "Some of that was just the retrovirals."

"You were exhibiting the complete list in the wake of the CARDS scare and the needle stick, which is why I made the executive decision to insist you take some leave."

"You didn't make a decision, I did. I'm still your boss." John suspects that what happened to Victor had made Sherlock want a bit of a breather, too, but he probably wouldn't want to admit to it.

"Your management duties were wearing your down. We were getting into a routine in many things at home, which is unacceptable."

"That's rich, since _you're_ my biggest management duty at work."

Sherlock's sunny smile disappears, and he busies himself with emptying the last of his glass of water.

John exhales, aware of what he's just done. "Look, I'm sorry. I know I sometimes take stuff out on you, but that works both ways. I'm not going to say you're doing well because that sounds bloody condescending, so I'm just going to say I'm glad you listen to me sometimes. I want to be there for you." Just like Sherlock had been there for him, after Afghanistan. "We've both had a tough time lately."

Sherlock meets his gaze, still trying to look neutral but John knows him well enough to read the dismay behind. "You always are there for me, and I _always_ listen to you."

John pats his bicep. "I know you do even when it doesn't always look like it. I don't want you to feel as though I'm on your case all the time. We've come a long way from two and a half years ago. As it turns out, managing you by the poolside is a lot more fun than doing it in rainy London. And you still pretty much manage things at least half the time in the bedroom, so we're even."

"I take it my choice of hotel has been approved?"

"Compliment fisher. I bloody love it. And you," John says pointedly. "Scoot." He shoves himself into the same sunbed, turning on his side to study the details of a mostly naked Sherlock. "And you're absolutely right that it's good to try to get the hang of this relaxing business again." He leans in to plant a kiss on Sherlock's cupid's bow, which then leads to something with a bit more tongue, up to the point when a group of women walking past them towards the small poolside bar give them a frown.

Sherlock had repeatedly called this a _Greek sex holiday_ when talking to their co-workers. And, it only made things worse when Sherlock had kept spouting out scientific facts about sex producing natural endorphins that combat stress and relieve mood issues. On the other hand, what does it even matter if they get a few chuckles? John doesn't want to change Sherlock when it comes to the things that are the essence of what makes him so fascinating, and sometimes he forgets that when he's busy trying to help Sherlock negotiate the social minefield of working at a large hospital. While he does need to be civil and not let his past issues cloud his judgment, he really doesn't need to get along with everyone. If someone won't accept those qualities of Sherlock's that make him who he is, those people don't deserve a single minute of his company. John, on the other hand, wants to make it his life's mission to be worthy of it.

"Is it always going to be like this?" he muses after they've disentangled. "Our lives, I mean. Time just flies by."

Sherlock stretches his arms above his head and wiggles his fingers, luxuriating in the warmth of the sun. "At work, you mean?"

"Our work _is_ our life, to a large extent. We'll always be busy, we'll always have to fight the bureaucracy, we'll always have annoying colleagues and annoying patients who don't know how good they have it here in the western world. We'll never have enough time for ourselves, normal people won't understand why our work is so stressful, we'll get wrinkles fast because of being on call and being sleep-deprived, and we'll always be exhausted."

"It is what it is, because we chose it. And sod normal people – what would you do with them now that you've got me?" Sherlock grins.

John nods. "Fair enough, but still: what sort of a self-destructive moron would choose to be a doctor?" he jokes. "It sucks out your soul sometimes."

Sherlock cocks his head, lip quirked in amusement. "Consider the fact that we can take a broken brain and _fix it_. We can save lives, and experience what just may be the ultimate power trip doing it. The only pertinent question should be: what _is_ the price we're willing to pay for such a thing?"

"A lot," John replies without hesitation. "Quite a lot."

This is one of Sherlock's great gifts: seeing the forest for the trees, finding the grain of truth in the midst of rubble, seeing the important things when others get lost in the surrounding white noise.

Sherlock rubs his palms up and down his shins. "The current medical system is what it is, but if we want to keep doing what we enjoy, it's the only possible framework available. All the other options for doing brain surgery are, regrettably, illegal."

The first thing that comes to John's mind is Sherlock absconding with a fresh corpse from a pathology department. The notion does not seem all _that_ far-fetched.

"I could use a drink," Sherlock says and extricates himself from their embrace, stretching as he stands up. "Can I get you something?"

"Seeing as we're on a Mediterranean holiday, _Sex on the beach_ wouldn't go amiss."

Sherlock blinks and his forehead does that adorable confused crinkly thing John loves. "You just told _me_ to keep my voice down."

John chuckles while turning on his stomach, then plants his face on the coarse linen of the sunbed. "It's a cocktail, you berk," he mutters. "We've still got a few hours before our restaurant reservation, so we might as well have a few while we wait."

He certainly feels like he needs a bit of liquid courage right now, considering what plans he has made regarding their dinner. He had thought that butterflies in the stomach would have been something he'd have left behind after his teen years, but today they are back with a vengeance. After all, he's about to do something he has never done before; something he has never even considered doing with anyone else than Sherlock. Well, technically, he _has_ done this once already with the man, but he hadn't fully understood what he was doing the last time. Not really. Now, he does. This time, instead of doing it because he has pressured himself into believing it's the right thing to do, he's certain he _is_ doing the right thing. He's sure of himself, of Sherlock, of the two of them together.

The parting words an ASD-specialised therapist he had talked to after Afghanistan had stuck with John: _'Don't leave Sherlock guessing; give him a road map of where the two of you are.'_  That's exactly what he intends to do tonight. It's time.

"I delete such pointless stuff as cocktail nomenclature, you know that," Sherlock announces with a pout that soon melts into a quirked-up lip.

"I know you do." John sits up, slaps Sherlock's left glute and shoves him towards the bar. "I love you," he adds before his partner disappears from hearing range.

  
-o-0-o-0-o-0-o-0-o-0-o-

  
One day later, John finds his fiancé sitting on their balcony, watching the moonlight reflecting off the endless-looking sea far below. The closest islands are half-hidden by the inky darkness, only their outlines made visible by the blue light.

John places two glasses of the same local, bone-dry assyrtiko wine they had both enjoyed at dinner last night. Then, he circles his arms around Sherlock's waist from the back, burying a kiss right next to the lowest curls on the nape of his neck. He can feel a tension in the shoulders onto which he slides his palms next.

He shifts slightly to the side to see Sherlock's expression, which is thoughtful as he looks into the distance. He's fingering the thin gold band John had ceremonially slipped onto his finger last night – for the second time.

After John's first – in hindsight somewhat misguided – proposal, they had fallen out of habit of wearing their engagement rings. Such jewellery isn't allowed at work and neither of them felt comfortable wearing one in a necklace after an initial period of doing so. They hadn't made wedding plans or even discussed whether they wanted one. For John, the proposal had been a token of a steady relationship, nothing more, but it had slowly turned into an unanswered question he hadn't realised was affecting Sherlock. In hindsight, John shouldn't have been surprised that the way their whole engagement seemed to have been forgotten had confused and distressed him, especially when their relationship had hit a rocky patch.

John wants that ring to mean more, now. So, he'd proposed again last night. And, again, he had received an enthusiastic " _Yes!_ " as his reply. This time, it had been a much less bewildered one.

The first time around, two years ago, they'd been in Italy. He had taken Sherlock's hand with a slightly wavering voice and asked, simply, if Sherlock would consider being his fiancé. He had not said _husband_ , not at first. He had not mentioned marriage. But, that was naturally the inevitable assumption. At first, he had only received a stare as his reply. A deer-in-headlights look. John had actually had to wave a hand in front of Sherlock's eyes to see if he had well and truly broken that magnificent brain.

"Sherlock?" It was been the third time John had called out his name. A waiter who had already walked past twice was starting to look a bit worried at Sherlock's downright petrified, furiously blinking silence.

Suddenly, the man seemed to come back online. "So, in fact---" he had trailed out, clearly expecting clarification.

"Yes, in fact," John had teased him. "You heard me."

"You--- you mean---" Sherlock had stammered, knocking over his wine glass.

The waiter reappeared with a cotton napkin and salvaged the mess. After Sherlock had a fresh, full glass in front of him, he reiterated: "I would be your----"

"---Husband?" John suggests.

Sherlock's brows had knitted together, and John had recognised the look – he was processing something quite feverishly. Finally, he presented the result of his analysis: " _Sherlock Holmes-Watson_?"

"If you like, but we could also just keep our old names," John had replied. "That name sounds a bit overly complicated, if you ask me, and I'm sure as hell not becoming John Holmes."

Sherlock's expression signalled that the reference to the vintage porn star has gone completely over his head. If anything, he looked a bit offended.

"I didn't mean that there's anything wrong with Holmes, it's just, it's the name of a semi-famous person I wouldn't want to be connected to." John had begun to worry that Sherlock was getting stuck in a tangent instead off addressing the pertinent point of yes/no, so he dug out the ring box.

"You are, in fact, serious?" Sherlock asked, eyes fixed on the box John had placed in front of him on the table next to his bread plate and opened to reveal the thin rose-gold band.

"Dead serious. Do you want me on one knee?"

"No, that's highly unnecessary," Sherlock had replied almost primly with a sweeping glance around the room to see if they were being eavesdropped. A few patrons in neighbouring tables had, in fact, spotted the box and were whispering among themselves.

"Do you need to think about it?" John asks. It would have been fine if that was the case. He hadn't taken this decision lightly, so Sherlock shouldn't, either.

Suddenly, Sherlock's eyes went wide. "I did say _yes_ ," he points out, confusion and indignation doing a strange dance on his features.

John bursts out laughing. "No, love, you didn't."

"I must have. I thought it. Instantly."

"I think you were a bit too surprised to think straight," John had told him, stood up, grabbed Sherlock's wrist and pulled him into a standing position for a proper engagement snog as the tables around them began to applaud.

Afterwards, things settled back into old routines. The rings eventually ended up in a drawer. John kept telling himself that it was still so early, that they hadn't made any concrete plans, that things were _good_. Until they weren't. Until John decided to go to Afghanistan for reasons he didn't entirely understand himself.

He does, now. In fact, last week Molly had suggested that it was time to end their therapeutic relationship.

"Am I cured, now?" John had joked, but there was a grain of truth in it. He hadn't had flashbacks for months. Things with Sherlock were – are – good. The thought of reaffirming their union and their future plans had crossed his mind dozens of times, but Molly's suggestion that no further therapy was needed was what had put wheels in motion in his head. After being wrapped up in himself after his injury, he was now ready to move on. Perhaps the events of the last few weeks have provided Sherlock some closure with the past, too. As morbid as it may appear, Victor had been a part of why John had begun to feel that the timing might now be right. Not because he was jealous; not because he needed to stake his territory. No, this was the right time to remind Sherlock of the future when the past seemed to be dragging him down. To remind him who he was and of the good choices he had made, and where that had lead him.

Molly had discouraged John from rushing into taking up the subject of marriage soon after they got over their worst patch during the halo thing. John had agreed after realising that the gesture could have been interpreted as exactly the sort of hastiness that his first proposal had been.

Now, the dust has settled. He has never felt closer to Sherlock as he has the past few months. So, last night, as they were walking home from the restaurant, John had dug out the ring – just the ring, no ceremonial box – and offered it to Sherlock. "I didn't think enough about what this actually meant when I gave it to you the last time. I just wanted to keep you, and I didn't want to seem less... eager than you to be together. This time, I've thought it through, and I'm doing this because I want to, not because I think I should. I want you to take this, if you want to keep me. If I'm worthy of you. Keep me, if I make you happy. I haven't always done that; things have been difficult lately, but we didn't give up. I love you."

Without a word, Sherlock had slipped the ring on, and laced their fingers together. Nothing more needed to be said. Even though there was no audience and no champagne and applause, it had finally felt the way John had expected it should. Safe. Permanent. Reassuring. Certain. Blissfully happy. John can't remember ever being prouder of anything in his life.

"I didn't know if you wanted me to wear it anymore," Sherlock admitted when John had his back turned, flashing their key card on their suite door. "I couldn't decide if and when you started regretting giving it to me."

The lock clicked open but John lingered in the doorway to look at him. The dim light from a garden lantern was all that illuminated them. It felt easier to talk in the faint light. "I never stopped loving you and wanting you and I'm sorry for not telling you that. I left a lot for you to just deduce."

"And I deduced wrong."

"No, you made reasonable assumptions based on the limited data you had," John quoted Sherlock back at himself. These sorts of moments really made John wonder why the hell had it been so impossible to open his mouth and say important things out loud instead of letting problems fester.

They settled into bed, both tired from being in the sun all day and from the wine and from the long walk back from the restaurant. John turned on the air conditioning, and Sherlock laid his head on John's good shoulder just like he always used to, before the halo. No further words were exchanged, but John didn't feel as though Sherlock had retreated into his head like he often did. John raked his fingers into the curls tickling his neck and before long, Sherlock's breathing slowed into that of sleep.

John must have drifted off soon after. But, sometime during the early hours of the night, he woke up and found the bed empty. On his way to the loo, he spotted Sherlock standing on the terrace, wrapped in a bathrobe. John had wondered if he should go out there, but in the end decided to give him a bit of space. Eventually, Sherlock came back to bed and pressed himself against John's back with a reassuringly contended sigh. In the morning, he'd seemed fine, but there have been more moments of withdrawn quiet. They can't have been brought on by the proposal since they had been occurring before it. Sherlock hasn't attempted to hide them, but he also has not volunteered an explanation as to what brings them on.

John has a hunch that one of them is happening now. Sherlock is biting his lip as he looks out to sea where the last rays of the setting sun are colouring the edge of the horizon.

"Are you thinking about him?" John asks quietly and takes a step towards the stone balustrade. Their arms are still nearly touching; John thinks he can feel the warmth of the body beside his own in the cool night air.

Sherlock slides his hands into the pockets of his white linen shorts. "Yes."

John tries to sift through his own feelings before saying anything more. Molly had taught him to think first and react second if something affects him but right now, he is almost surprised to find that he's not worried at all why Sherlock would be spending some of the precious moments of their _Greek sex holiday_ thinking about Victor Trevor.

Sherlock is studying his expression. "Sorry. I--- I recognise that may be inappropriate."

"It's alright, I promise."

"I don't know if he had anyone. He probably never had anything like this, like us, right now. Safe. Not a care in the world," Sherlock says, shifting his gaze to watch the black waves below.

"He had you. You didn't abandon him."

"I wish it were that simple. We fell apart. He said some things. I said some things. I realised I had to choose to follow him or to do something more with my life. One night we fought over rent money he had, once again, whittled away by restocking his stash. I went to the Maughan Library since Victor locked me out of the flat and it was open late. There was a highlight exhibition on neuroscience in the main hall. I picked up a book called _'Understanding Other Minds: Perspectives from developmental social neuroscience'_. Read it from cover to cover that night. I'd read other texts on the subject before, but that one explained the neuroscience in a way that sparked an intense fascination in the field. Before, I just wanted the practical information on how I could fix--- me. That book made me wonder what sorts of things neuroscience and neurosurgery actually _could_ fix."

John smiles and places his palms on the edge of the balustrade. Down below, on the slopes of the steep island, lights and sound from countless houses can be seen and heard. "We never know where wewillend up, it's not all under our control. We never know where our choices will lead us. I don't know if you've ever thought like that, or if you think it's a bit offensive since things went to hell afterwards, but I can't help but wonder if we'd be where we are now if I hadn't gone to Afghanistan."

"It's a fair question. Would I have attended medical school, if Victor hadn't spent our rent on crystal meth?"

"Would he be where he is now, if his father hadn't been a fucking tosser?" John asks. "Would this have happened long ago, if you hadn't been there for him?" John can't know how much of an influence Sherlock had been on Victor, but as surprising as it is, it seems that his genius, mad, impulsive, routine-averse, scatterbrain partner who often forgets to pay bills and close the fridge door just may have been the more sensible of the two young men.

"It could have been me," Sherlock says quietly. "What happened to him, it could have happened to the both of us."

"Don't ever feel guilty that it didn't. You were trying to work out how to fix yourself, and he should have told you that you didn't have to. I should tell you that more often."

"I wrote to him once, from Scotland. I doubt the letter was ever delivered."

John doesn't ask what that letter had said. Sherlock will tell him if he wants to, but John doesn't think he has the right to ask. The problems of Sherlock's past are Sherlock's business; the problems of their future are John's privilege.

"If I'd stayed with him, it's likely I would not be here. You told me not to throw away the years I've spent sober. I don't intend to."

"I know. You came to me that day – you can _always_ come to me."

Sherlock reaches out for one of the wine glasses, and lets out a ragged, hollow laugh. "I keep thinking that if my and Victor's lives hadn't gone their respective paths, I wouldn't have met you. It's stupid, I know, but it bothers me."

"Magical thinking is what it is – that he somehow paid for your happiness. It doesn't work like that." Molly had told John that thoughts are thoughts; just a brain doing acid tests on different scenarios, and people shouldn't beat themselves up over such things. _They're just thoughts._

"I don't miss the person he became during the last months of our acquaintance. I don't want to see that person again. But, I miss... him." he swallows. "I wish you had met him. Properly, I mean; met the person he was before---"

"I wish I'd met him, too," John tells him and places his palm on top of Sherlock's hand on the balustrade, curing the long fingers inside his palm, then lacing them together with his own. It has always seemed like a very important thing for Sherlock to hold hands; he always initiates it so carefully and meticulously as though he's still afraid John would withdraw. He should return the gesture more often. "He was important to you."

Sherlock leans away so that he can pass John the other glass of wine. "Not like you are," he replies John pointedly.

"You don't have to keep telling me that." Sherlock and Victor had not been romantically involved, but in hindsight it seems obvious that they had been _together_ , in some sense of the word. And, it's all fine. Only a lowly man would be jealous of the dead, and John knows he cannot stake a claim to Sherlock's past any more than Sherlock has the right to crucify him for his past relationships or mistakes made prior to their first meeting.

John had talked to Molly about Victor during their last appointment. Molly had helped him see a pattern there: Sherlock, staying in a relationship despite all the odds being stacked against its success, because he did not believe he'd even find someone again.

John is not Victor. He has stayed. He has sought help when he couldn't cope so that he could salvage their relationship. He _can_ give Sherlock all those things that he wants and deserves, because he loves Sherlock back.

"He told me to find someone else, someone who could be what he couldn't. That was on the night when he locked me out after I shouted at him," Sherlock explains. "I think he felt guilty. I think he wanted me gone, because we were not going to be what I wanted and that made things complicated. That's part of why I would have wanted him to meet you, to tell him he was right."

It seems that Sherlock keeps saying such things because he feels at least a bit guilty for being so affected by Victor's passing. He's trying to seek absolution from John for what he may or may not have felt for someone else.

John extricates his hand and wraps the arm around Sherlock's waist. "You have nothing to feel guilty for."

Love shouldn't be quantifiable. It shouldn't be measured or compared. He doesn't doubt that Sherlock loves him, especially not after their reconciliation during Sherlock's halo treatment and the realisations about their relationship John has arrived at during his therapy with Molly. Sherlock having loved someone else in a way that may be difficult to even define is not a threat; it's just life well-lived. Maybe Sherlock wouldn't stay with someone even if that relationship was destroying him just because he thinks he can't find anyone else. Maybe he stays because he sees something worth fighting for. Something that could survive. He's not weak. He never was.

 _A life well-lived, nothing more and nothing less._ Water under the bridge, just as Mycroft Holmes had said.

"I love you," John tells him. "It's alright, Sherlock. It's all fine."

"I'm tempted to believe you. That it's fine. That _we're_ fine, when you say it like that."

"Then believe it, because I mean every word."

Sherlock's thoughtful frown suddenly melts into the sort of disinhibited smile he only ever gives to John. It makes him looks as though he is so surprised at what he has that he is about to burst from pride and happiness. He raises his glass for John to clink his own against it. "To serendipity," he offers.

"To serendipity," John confirms. "And to absent friends."

  
  
**––– The end of part 7/10 of _ **You Go To My Head**_ –––**

**Notes for the Chapter:**

> I am honoured and amazed at the reception to this story. I love you all, and promise that our doctor boys will return later this year – there are three more stories already drafted.
> 
> But, before that.... Starting on the 1st of July, we are due for a different sort of AU adventure:
> 
> [Video trailer](https://youtu.be/gMD4CFXPtZc) for _**Drift Compatible**_.


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